Provider Demographics
NPI:1538508296
Name:WELLS, MARY HUERTER (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:HUERTER
Last Name:WELLS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:MERETA
Other - Last Name:HUERTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8303 DODGE ST STE 250
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-4108
Mailing Address - Country:US
Mailing Address - Phone:402-334-4773
Mailing Address - Fax:402-330-7463
Practice Address - Street 1:8303 DODGE ST STE 250
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-4108
Practice Address - Country:US
Practice Address - Phone:402-334-4773
Practice Address - Fax:402-330-7463
Is Sole Proprietor?:No
Enumeration Date:2013-06-17
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE6963207R00000X
NE29610207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine