Provider Demographics
NPI:1467733006
Name:WELLS, SHEVONNE KATHERINE (DPM)
Entity Type:Individual
Prefix:DR
First Name:SHEVONNE
Middle Name:KATHERINE
Last Name:WELLS
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:695 KINKAID RD
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21402-1006
Mailing Address - Country:US
Mailing Address - Phone:410-293-4378
Mailing Address - Fax:410-293-1255
Practice Address - Street 1:695 KINKAID RD
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21402-1006
Practice Address - Country:US
Practice Address - Phone:410-293-4378
Practice Address - Fax:410-293-1255
Is Sole Proprietor?:No
Enumeration Date:2011-09-08
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC006318213ES0103X, 213ES0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery