Provider Demographics
NPI:1568410215
Name:WELDEN, SCOTT R (MD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:R
Last Name:WELDEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:872 OHIO PIKE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45245-2204
Mailing Address - Country:US
Mailing Address - Phone:513-947-8346
Mailing Address - Fax:513-752-6695
Practice Address - Street 1:872 OHIO PIKE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45245-2204
Practice Address - Country:US
Practice Address - Phone:513-947-8346
Practice Address - Fax:513-752-6695
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35075182W207P00000X
OH35075182202K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No202K00000XAllopathic & Osteopathic PhysiciansPhlebology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2089332Medicaid
000000344438OtherBCBS
OH2089332Medicaid
G87466Medicare UPIN