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NPI Code Detail

MEDICARE: DR. CHARLES VINCENT WELLMAN M.D.

MEDICARE: DR. CHARLES VINCENT WELLMAN M.D.
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
1207R00000XInternal Medicine Physician35.047616OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
135.047616OTHEROHSTATE LICENSE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093887382
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHARLES VINCENT WELLMAN M.D.
Provider Business Mailing Address
First Line : 300 E 185TH ST
Second Line :
City : CLEVELAND
State : OH
Zip : 44119-1330
Country : US
Telephone Number : 216-383-3775
Fax Number : 216-383-3750
Provider Business Practice Location Address
First Line : 300 E 185TH ST
Second Line :
City : CLEVELAND
State : OH
Zip : 44119-1330
Country : US
Telephone Number : 216-383-3775
Fax Number : 216-383-3750
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2006
Last Update Date : 07/08/2007

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Directions to “ DR. CHARLES VINCENT WELLMAN M.D.” Practice Location

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