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General NPI Number Information
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NPI Number | 1801181136
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Entity Type | Individual
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Provider Name | SHARI L WELLEN MD
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Gender | Female
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Dates
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Enumeration Date | 06/15/2011
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Last Update Date | 01/19/2024
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Provider Practice Location Address
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Address Line | 22 BRAMHALL ST
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City | PORTLAND
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State | ME
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Zip | 04102-3134
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Country | US
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Telephone | 207-662-1400
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Fax |
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Provider Business Mailing Address
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Address Line | 22 BRAMHALL ST PEDIATRIC HOSPITALIST MEDICINE
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City | PORTLAND
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State | ME
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Zip | 04102-3175
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number | MD20161
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number | D74547
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number | MD431977
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | MD20161
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License Number State | ME
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