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NPI Code Detail

MEDICARE: DR. MICHAEL G WELLS D.O.

MEDICARE:  DR. MICHAEL G WELLS  D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician101616MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033181367
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL G WELLS D.O.
Provider Business Mailing Address
First Line : 11605 E 23RD ST S
Second Line :
City : INDEPENDENCE
State : MO
Zip : 64050-4201
Country : US
Telephone Number : 816-579-6891
Fax Number :
Provider Business Practice Location Address
First Line : 11605 E 23RD ST S
Second Line :
City : INDEPENDENCE
State : MO
Zip : 64050-4201
Country : US
Telephone Number : 816-579-6891
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2006
Last Update Date : 08/31/2023

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Directions to “ DR. MICHAEL G WELLS D.O.” Practice Location

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