Provider Demographics
NPI:1376143941
Name:WELCH, WANDA (CPC, CBCS)
Entity Type:Individual
Prefix:
First Name:WANDA
Middle Name:
Last Name:WELCH
Suffix:
Gender:F
Credentials:CPC, CBCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1487 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201-6507
Mailing Address - Country:US
Mailing Address - Phone:478-361-0907
Mailing Address - Fax:
Practice Address - Street 1:2720 SHERATON DR STE 170
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31204-6806
Practice Address - Country:US
Practice Address - Phone:478-219-9709
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-31
Last Update Date:2020-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA01454979246YC3302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246YC3302XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health InformationCoding Specialist, Physician Office Based