Provider Demographics
NPI:1740278183
Name:WELKER, ROBERT W (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:W
Last Name:WELKER
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 1:195 W TELEGRAPH ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84780-1675
Mailing Address - Country:US
Mailing Address - Phone:435-628-4444
Mailing Address - Fax:435-628-4447
Practice Address - Street 1:195 W TELEGRAPH ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:UT
Practice Address - Zip Code:84780-1675
Practice Address - Country:US
Practice Address - Phone:435-628-4444
Practice Address - Fax:435-628-4447
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1768961205207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT5950150OtherAETNA
UT76896120500001OtherBLUE CROSS/BLUE SHIELD
UT292798OtherDESERET MUTUAL BENEFIT AS
UT870680102OtherUNITED HEALTH CARE
UTP00315542OtherRAIL ROAD MEDICARE
UT11033825OtherCIGNA
UT107009756101OtherSELECTHEALTH
UT11033825OtherUNITED AMERICAN
UT76896120500001OtherBLUE CROSS FED
UT870680102OtherMAILHANDLER
UT88198OtherPUBLIC EMPLOYEE HEALTH PL
UTC98260OtherTRICARE
UT870680102OtherEDUCATOR'S HEALTH CARE
UT292798OtherDESERET MUTUAL BENEFIT AS
UTC98260Medicare UPIN