Provider Demographics
NPI:1902853260
Name:WELSH, DONALD WILLS (MD)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:WILLS
Last Name:WELSH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:DONALD
Other - Middle Name:W
Other - Last Name:WELSH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2147 RIVERCHASE OFFICE RD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35244-1836
Mailing Address - Country:US
Mailing Address - Phone:205-403-8902
Mailing Address - Fax:205-982-0278
Practice Address - Street 1:1680 MONTGOMERY HWY
Practice Address - Street 2:AMERICAN FAMILY CARE INC
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35216
Practice Address - Country:US
Practice Address - Phone:205-979-0888
Practice Address - Fax:205-979-4110
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL7216207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL110178802OtherRAILROAD MEDICARE
AL28950OtherBLUE CROSS BLUE SHIELD
AL009949320Medicaid
C74328Medicare UPIN
AL28950OtherBLUE CROSS BLUE SHIELD