Provider Demographics
NPI:1043280571
Name:WELLS, PAUL CALVIN (DC)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:CALVIN
Last Name:WELLS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 E WT HARRIS BLVD
Mailing Address - Street 2:SUITE G
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28213-4104
Mailing Address - Country:US
Mailing Address - Phone:704-547-9494
Mailing Address - Fax:
Practice Address - Street 1:1001 E WT HARRIS BLVD
Practice Address - Street 2:SUITE G
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28213-4104
Practice Address - Country:US
Practice Address - Phone:704-547-9494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-26
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2415111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC606928OtherUHC PROVIDER NO.
NC085NYOtherBCBS PROVIDER NO.
NCU64860Medicare UPIN
NC2457749Medicare ID - Type UnspecifiedPERFORMING PROVIDER NO.