Provider Demographics
NPI:1790862977
Name:WELLNER, ROBERT LEO (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LEO
Last Name:WELLNER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1461 COLESVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-5221
Mailing Address - Country:US
Mailing Address - Phone:610-442-7807
Mailing Address - Fax:609-895-1032
Practice Address - Street 1:1461 COLESVILLE RD
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18015-5221
Practice Address - Country:US
Practice Address - Phone:610-442-7807
Practice Address - Fax:609-895-1032
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB07771400207LP2900X
PAOS011916207LP2900X, 207L00000X
CA20A8689207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0094463Medicaid
PA22-1994560OtherDEVON
50065555OtherKEYSTONE HEALTH PLAN CENTRAL
PA50078774OtherCAPITAL BLUE CROSS
PA7441837OtherAETNA
PA22-1994560OtherHEALTH AMERICA/HEALTH ASSURANCE
2797879000OtherAMERIHEALTH
4729920OtherCIGNA HEALTHCARE
P00448881OtherRAILROAD MEDICARE
PAP00661480OtherRAILROAD MEDICARE
2261859OtherUNITED HEALTHCARE
2797879000OtherINDEPENDENCE BLUE CROSS
50065555OtherCAPITAL BLUE CROSS
PA50078774OtherKEYSTONE HEALTH PLAN CENTRAL
107840OtherGEISINGER HEALTH PLAN
1537403OtherGATEWAY HEALTH PLAN
PA22-1994560OtherFIRST MCO
PA22-1994560OtherPROCURA MANAGEMENT
PA113861400OtherDEPARTMENT OF LABOR
1928843OtherHIGHMARK BLUE SHIELD
PA22-1994560OtherUNITED HEALTHCARE
2797879000OtherKEYSTONE HEALTH PLAN EAST
2797879000OtherAMERIHEALTH
NJ0094463Medicaid
PA065058Medicare PIN
P00448881OtherRAILROAD MEDICARE
PAH75141Medicare UPIN