Provider Demographics
NPI:1558701714
Name:WELLMAN, ANDREW SCOT (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:SCOT
Last Name:WELLMAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-1219
Mailing Address - Country:US
Mailing Address - Phone:304-523-3502
Mailing Address - Fax:
Practice Address - Street 1:111 4TH AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-1219
Practice Address - Country:US
Practice Address - Phone:304-523-3502
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-02
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0007931183500000X
OH03131989183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist