MEDICARE: DR. VALERIE B WELCH MD

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	208000000X	Pediatrics Physician	2008016041	MO

General Provider Information

NPI Number	:	1255348819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VALERIE B WELCH MD

Provider Business Mailing Address
First Line	:	PO BOX 4699
Second Line	:
City	:	LAFAYETTE
State	:	IN
Zip	:	47903-4699
Country	:	US
Telephone Number	:	765-446-5417
Fax Number	:	765-446-5317

Provider Business Practice Location Address
First Line	:	3774 BAYLEY DR STE B
Second Line	:
City	:	LAFAYETTE
State	:	IN
Zip	:	47905
Country	:	US
Telephone Number	:	765-807-8180
Fax Number	:	765-807-8181

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

Provider Enumeration Date	:	08/03/2006
Last Update Date	:	03/23/2021

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