MEDICARE: DR. PAUL CALVIN WELLS D.C.

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
1	111N00000X	Chiropractor	2415	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	606928	OTHER	NC	UHC PROVIDER NO.
2	085NY	OTHER	NC	BCBS PROVIDER NO.

General Provider Information

NPI Number	:	1043280571
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL CALVIN WELLS D.C.

Provider Business Mailing Address
First Line	:	1001 E WT HARRIS BLVD
Second Line	:	SUITE G
City	:	CHARLOTTE
State	:	NC
Zip	:	28213-4104
Country	:	US
Telephone Number	:	704-547-9494
Fax Number	:

Provider Business Practice Location Address
First Line	:	1001 E WT HARRIS BLVD
Second Line	:	SUITE G
City	:	CHARLOTTE
State	:	NC
Zip	:	28213-4104
Country	:	US
Telephone Number	:	704-547-9494
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2006
Last Update Date	:	02/25/2013

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