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General NPI Number Information
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NPI Number | 1689733925
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Entity Type | Organization
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Legal Business Name | EUGENE C WELLS MD PA
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1720 DAVIE AVE
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City | STATESVILLE
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State | NC
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Zip | 28677
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Country | US
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Telephone | 704-871-0081
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Fax | 704-871-0086
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Provider Business Mailing Address
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Address Line | PO BOX 1164
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City | STATESVILLE
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State | NC
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Zip | 28687
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Country | US
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Telephone | 423-768-2525
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Fax | 423-768-2525
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Authorized Official
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Title or Position | PRESIDENT
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Name | EUGENE C WELLS
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Credential | MD
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Telephone | 423-768-2525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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