Provider Demographics
NPI:1558319194
Name:WELCH, ARTHUR S (PA)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:S
Last Name:WELCH
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:50 FAIR HARBOUR PL
Mailing Address - Street 2:SUITE 2-A
Mailing Address - City:NEW LONDON
Mailing Address - State:CT
Mailing Address - Zip Code:06320-4731
Mailing Address - Country:US
Mailing Address - Phone:860-442-0564
Mailing Address - Fax:860-439-0808
Practice Address - Street 1:50 FAIR HARBOUR PL
Practice Address - Street 2:SUITE 2-A
Practice Address - City:NEW LONDON
Practice Address - State:CT
Practice Address - Zip Code:06320-4731
Practice Address - Country:US
Practice Address - Phone:860-442-0564
Practice Address - Fax:860-439-0808
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT001123363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTD400055103OtherMEDICARE
CT1558319194Medicaid