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CHARLES W. WELLY D.O.
>> Family Medicine >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1700956414
Individual Registrant: CHARLES W. WELLY D.O.
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
5 W BACK ST STE 101 FINCASTLE, VA 24090-4368 US
Tel: 540-769-3964 Fax: 540-473-3458
Tel: 540-769-3964 Fax: 540-473-3458
Contact information for business:
PO BOX 8310 ROANOKE, VA 24014-0310 US
Tel: 540-345-3556 Fax: 540-342-2193
Tel: 540-345-3556 Fax: 540-342-2193
Registration Information:
NPI: 1700956414
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 207Q00000X | Allopathic & Osteopathic Physicians Family Medicine | AZ | 2248 |
| Y | 207Q00000X | Allopathic & Osteopathic Physicians Family Medicine | VA | 0102204907 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
