Provider Demographics
NPI:1740212471
Name:WELSH, TODD SAMUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:SAMUEL
Last Name:WELSH
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 1:14050 NW 14TH ST
Mailing Address - Street 2:TEAMHEALTH - STE 190
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-2865
Mailing Address - Country:US
Mailing Address - Phone:800-424-3672
Mailing Address - Fax:954-377-3042
Practice Address - Street 1:18697 BAGLEY RD
Practice Address - Street 2:SOUTHWEST GENERAL HEALTH CENTER - EMERGENCY DEPARTMENT
Practice Address - City:MIDDLEBURG HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-3417
Practice Address - Country:US
Practice Address - Phone:440-816-5525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY223542207P00000X
OH35.088919207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02409254Medicaid
NY7306469OtherAETNA
NY9731883OtherGHI
NY223542-2WOtherWORKERS' COMPENSATION
OHWE4197711Medicare PIN
NY9731883OtherGHI
NY7306469OtherAETNA