Doctor Name: | DR. ADAM WELLER |
NPI Number: | 1568634855 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | M-12492 |
Business Practice Address: | 1000 State St Mccall, ID - 836383704 |
Business Phone Number: | 2086342221 |
Business Fax Number: | 2086347112 |
Mailing Address: | 190 E Bannock St, BOISE |
State: | ID |
Postal Code: | 837126241 |
Phone Number: | 2086342221 |
Fax Number: | |
NPI Enumeration Date: | 03/27/2008 |
NPI Last Update Date: | 02/11/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085R0202X |
License Number: | M-12492 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Diagnostic Radiology |
Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |