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NPI Code Detail

MEDICARE: VITREORETINAL ASSOCIATES PLLC

MEDICARE: VITREORETINAL ASSOCIATES PLLC
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
1207W00000XOphthalmology Physician

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 : 1134178460
Entity Type Code : Organization
Provider Name (Legal Business Name) : VITREORETINAL ASSOCIATES PLLC
Provider Business Mailing Address
First Line : 1221 MADISON ST
Second Line : SUITE 1002
City : SEATTLE
State : WA
Zip : 98104-3588
Country : US
Telephone Number : 206-215-3850
Fax Number : 206-215-3870
Provider Business Practice Location Address
First Line : 1221 MADISON ST
Second Line : SUITE 1002
City : SEATTLE
State : WA
Zip : 98104-3588
Country : US
Telephone Number : 206-215-3850
Fax Number : 206-215-3870
Authorized Official
Title or Position : OWNER
Name : DR. CRAIG G WELLS
Credential : M.D.
Telephone Number : 206-215-3850
Provider Enumeration Date : 05/05/2006
Last Update Date : 08/22/2020

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Directions to “VITREORETINAL ASSOCIATES PLLC ” Practice Location

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