Physician Compare National (NPI:1982709580)

HEALTHCARE PROVIDER: KEVIN MICHAEL WELCH DPM

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1982709580
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8224135918
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20150116001346
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	WELCH
	Individual professional last name
Provider First Name	KEVIN
	Individual professional first name
Provider Middle Name	MICHAEL
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	TEMPLE UNIVERSITY SCHOOL OF PODIATRIC MEDICINE
	Individual professional's medical school
Graduation Year	1989
	Individual professional's medical school graduation year
Primary Specialty	PODIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	966 CARPENTER RD
	Group Practice or individual's line 1 address
City	MILTON
	Group Practice or individual's city
State	PA
	Group Practice or individual's state
Zip Code	178477527
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5707429636
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	390045
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	WILLIAMSPORT REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	390013
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	EVANGELICAL COMMUNITY HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y