Provider Demographics
NPI:1649383605
Name:WELCH, CARL L (MD)
Entity Type:Individual
Prefix:
First Name:CARL
Middle Name:L
Last Name:WELCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 890273
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28289-0273
Mailing Address - Country:US
Mailing Address - Phone:828-324-1699
Mailing Address - Fax:828-324-0281
Practice Address - Street 1:221 13TH AVENUE PL NW
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-2596
Practice Address - Country:US
Practice Address - Phone:828-324-1699
Practice Address - Fax:828-324-0281
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC15811207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC15811OtherLICENSE - NC
NC1011VOtherBCBS PROVIDER NUMBER
NC8986424Medicaid
NC8986424Medicaid
NC201231BMedicare Oscar/Certification
NCBW0157619OtherDEA - NC
NC201231AMedicare ID - Type UnspecifiedMEDICARE NC
NC201231HMedicare Oscar/Certification
NC8986424Medicaid
NC201231FMedicare Oscar/Certification
NC201231EMedicare Oscar/Certification
NCC80542Medicare UPIN
NC201231GMedicare Oscar/Certification