Provider Demographics
NPI:1841201290
Name:WASHINGTON, WELTON CRAIG JR (MD)
Entity Type:Individual
Prefix:DR
First Name:WELTON
Middle Name:CRAIG
Last Name:WASHINGTON
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:555 TOWNER ST
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48198-5752
Mailing Address - Country:US
Mailing Address - Phone:734-544-6820
Mailing Address - Fax:734-544-2906
Practice Address - Street 1:555 TOWNER ST
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48198-5752
Practice Address - Country:US
Practice Address - Phone:734-544-6820
Practice Address - Fax:734-544-2906
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2012-03-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI43010798372084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry