Provider Demographics
NPI:1942211305
Name:WELKER, MICHAEL CHARLES (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:CHARLES
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 1:4000 MIAMISBURG CENTERVILLE RD STE 230
Mailing Address - Street 2:
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-7615
Mailing Address - Country:US
Mailing Address - Phone:937-433-5309
Mailing Address - Fax:937-247-5154
Practice Address - Street 1:4000 MIAMISBURG CENTERVILLE RD STE 230
Practice Address - Street 2:
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342-7615
Practice Address - Country:US
Practice Address - Phone:937-433-5309
Practice Address - Fax:937-247-5154
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-07-5671-W207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH349755OtherANTHEM
OH2140098Medicaid
OH7712008OtherAETNA
OHP00198095OtherMEDICARE ID
OH4102102Medicare ID - Type Unspecified
OHP00198095OtherMEDICARE ID
OH2140098Medicaid