Provider Demographics
NPI:1114914942
Name:WELCH, JOSEPH JACKSON III (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:JACKSON
Last Name:WELCH
Suffix:III
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 1:106 PINE BLUFF RD
Mailing Address - Street 2:SUITE 13
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-7161
Mailing Address - Country:US
Mailing Address - Phone:410-546-5255
Mailing Address - Fax:410-546-5255
Practice Address - Street 1:106 PINE BLUFF RD
Practice Address - Street 2:SUITE 13
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-7161
Practice Address - Country:US
Practice Address - Phone:410-546-5255
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0024818207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
26790OtherCOVENTRY
8969JJOtherBCBS NATIONAL CAPITAL
8005778567OtherUNITED HEALTHCARE
W189OtherBCBS FEDERAL
22666OtherMANSI
MD42258602OtherCAREFIRST
W189OtherBCBS FEDERAL
8005778567OtherUNITED HEALTHCARE