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General NPI Number Information
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NPI Number | 1891796512
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Entity Type | Individual
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Provider Name | MARY R WELCH MD
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Gender | Female
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Dates
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Enumeration Date | 08/03/2005
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 565 ABBOTT RD DEPARTMENT OF PHYSICAL MEDICINE AND REHABILITATION
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City | BUFFALO
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State | NY
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Zip | 14220-2039
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Country | US
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Telephone | 716-828-8260
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Fax | 716-828-3563
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Provider Business Mailing Address
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Address Line | 3 DALE RD
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City | ORCHARD PARK
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State | NY
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Zip | 14127-3508
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Country | US
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Telephone | 716-655-2690
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Fax | 716-655-2691
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 190403
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License Number State | NY
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