MEDICARE: ADRIAN WELLS

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	332BC3200X	Customized Equipment (DME)

General Provider Information

NPI Number	:	1528702941
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADRIAN WELLS

Provider Business Mailing Address
First Line	:	3517 STAR MAGNOLIA PL APT A
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46205-3353
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3517 STAR MAGNOLIA PLACE
Second Line	:	APT A
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46205
Country	:	US
Telephone Number	:	234-281-9237
Fax Number	:

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

Provider Enumeration Date	:	04/21/2022
Last Update Date	:	04/21/2022

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Directions to “ ADRIAN WELLS ” Practice Location

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