Provider Demographics
NPI:1093714297
Name:WELCH, MICHAEL C (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:C
Last Name:WELCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4701 CREEK RD
Mailing Address - Street 2:STE 110
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-8398
Mailing Address - Country:US
Mailing Address - Phone:513-733-8894
Mailing Address - Fax:513-733-8588
Practice Address - Street 1:4701 CREEK RD
Practice Address - Street 2:STE 110
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-8398
Practice Address - Country:US
Practice Address - Phone:513-733-8894
Practice Address - Fax:513-733-8588
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35036433207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH200011148OtherMEDICARE RAILROAD
OH1872262001OtherCIGNA
OH0363584Medicaid
OH000000004417OtherANTHEM
OH0920344OtherUNITED HEALTHCARE
OHWE0448366Medicare PIN
OH0920344OtherUNITED HEALTHCARE
OHH247260Medicare PIN
OH0363584Medicaid