Provider Demographics
NPI:1225512049
Name:WELSH, RONALD EDWARD
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:EDWARD
Last Name:WELSH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 TYLER AVE
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26301-3852
Mailing Address - Country:US
Mailing Address - Phone:304-695-0066
Mailing Address - Fax:
Practice Address - Street 1:335 TYLER AVE
Practice Address - Street 2:
Practice Address - City:CLARKSBURG
Practice Address - State:WV
Practice Address - Zip Code:26301-3852
Practice Address - Country:US
Practice Address - Phone:304-695-0066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-18
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant