Provider Demographics
NPI:1578596409
Name:WELLMAN, DAVID ANDREW (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ANDREW
Last Name:WELLMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:300 ROSEWOOD DR
Mailing Address - Street 2:SUITE 104
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-1389
Mailing Address - Country:US
Mailing Address - Phone:978-774-7243
Mailing Address - Fax:978-774-7421
Practice Address - Street 1:1505 COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-3605
Practice Address - Country:US
Practice Address - Phone:617-783-1441
Practice Address - Fax:617-783-1448
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA207966207R00000X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ23996OtherBCBS PROVIDER NUMBER
MAJ23996OtherBCBS PROVIDER NUMBER
MAH38122Medicare UPIN