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CHARLES W. WELLY D.O.

>> Family Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1700956414

Individual Registrant:
 CHARLES W. WELLY D.O.
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

Contact information for business:
PO BOX 8310  ROANOKE, VA 24014-0310 US
Tel: 540-345-3556  Fax: 540-342-2193

Registration Information:
NPI: 1700956414
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N207Q00000XAllopathic & Osteopathic Physicians
Family Medicine
AZ2248
Y207Q00000XAllopathic & Osteopathic Physicians
Family Medicine
VA0102204907

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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