MEDICARE: PAUL G 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	207RN0300X	Nephrology Physician	D0036460	MD
2	207RN0300X	Nephrology Physician	21663	WV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548259146
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL G WELCH MD

Provider Business Mailing Address
First Line	:	12931 OAK HILL AVE
Second Line	:
City	:	HAGERSTOWN
State	:	MD
Zip	:	21742-2914
Country	:	US
Telephone Number	:	301-797-9600
Fax Number	:	301-797-3854

Provider Business Practice Location Address
First Line	:	103 MARCLEY DR
Second Line	:
City	:	MARTINSBURG
State	:	WV
Zip	:	25401-2977
Country	:	US
Telephone Number	:	304-263-0911
Fax Number	:	304-263-0896

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

Provider Enumeration Date	:	10/17/2005
Last Update Date	:	06/11/2010

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