MEDICARE: DR. WELLS MARTIN III 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
1	174400000X	Specialist	24268	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	300033904	OTHER	NC	RAILROAD MEDICARE
5	P00197098	OTHER	NC	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00197098	OTHER	NC	RRMC - INDIVIDUAL
3	54504	OTHER	NC	BCBSNC
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134107287
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WELLS MARTIN III M.D.

Provider Business Mailing Address
First Line	:	1304 KENSINGTON DR
Second Line	:
City	:	HIGH POINT
State	:	NC
Zip	:	27262-7318
Country	:	US
Telephone Number	:	336-885-9211
Fax Number	:	336-885-9210

Provider Business Practice Location Address
First Line	:	109 MUIRS CHAPEL RD
Second Line	:	STE 100
City	:	GREENSBORO
State	:	NC
Zip	:	27410-6161
Country	:	US
Telephone Number	:	336-542-2900
Fax Number	:	336-542-2929

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

Provider Enumeration Date	:	01/08/2006
Last Update Date	:	09/12/2012

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Directions to “ DR. WELLS MARTIN III M.D.” Practice Location

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