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1154305258

NPI Code Detail

MEDICARE: SHELLEY MARIE WELLS DO

MEDICARE: SHELLEY MARIE WELLS DO

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	207L00000X	Anesthesiology Physician	42287	MN
2	207L00000X	Anesthesiology Physician	4301	IA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
12	15D87WE	OTHER	MN	BCBS/MEDICARE SUPPLEMENT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	21714	OTHER	MN	SIOUX VALLEY
2	HP36388	OTHER	MN	HEALTH PARTNERS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	20-01845	OTHER	MN	MEDICA
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MH904102684	OTHER	MN	PPO
7	15D87WE	OTHER	MN	BCBS
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	882882	OTHER	MN	ARAZ
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	7312	OTHER	MN	AVERA
13	A045	OTHER	MN	CHAMPUS

General Provider Information

NPI Number	:	1154305258
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHELLEY MARIE WELLS DO

Provider Business Mailing Address
First Line	:	1316 S MAIN ST
Second Line	:
City	:	CLARION
State	:	IA
Zip	:	50525-2019
Country	:	US
Telephone Number	:	515-602-9833
Fax Number	:	866-993-9501

Provider Business Practice Location Address
First Line	:	1316 S MAIN ST
Second Line	:
City	:	CLARION
State	:	IA
Zip	:	50525-2019
Country	:	US
Telephone Number	:	515-532-3119
Fax Number	:	515-532-3119

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

Provider Enumeration Date	:	12/01/2005
Last Update Date	:	09/24/2024

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Directions to “ SHELLEY MARIE WELLS DO” Practice Location

Language	Start Address	Practice Location

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