Provider Demographics
NPI:1669860870
Name:WELLMAN, HENRY NELSON (MD)
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:NELSON
Last Name:WELLMAN
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 1:5747 NE 61ST AVENUE RD
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34488-1243
Mailing Address - Country:US
Mailing Address - Phone:352-236-0895
Mailing Address - Fax:
Practice Address - Street 1:5747 NE 61ST AVENUE RD
Practice Address - Street 2:
Practice Address - City:SILVER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34488-1243
Practice Address - Country:US
Practice Address - Phone:352-236-0895
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-23
Last Update Date:2014-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01024231A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine