Provider Demographics
NPI:1942545538
Name:WELLS, HAWEY ADOLPHUS JR (MD)
Entity Type:Individual
Prefix:DR
First Name:HAWEY
Middle Name:ADOLPHUS
Last Name:WELLS
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:853 COMSTOCK DR
Mailing Address - Street 2:
Mailing Address - City:SHEPHERDSTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:25443-3642
Mailing Address - Country:US
Mailing Address - Phone:304-671-5531
Mailing Address - Fax:305-453-5382
Practice Address - Street 1:3 RAINBOW DR
Practice Address - Street 2:
Practice Address - City:KEY LARGO
Practice Address - State:FL
Practice Address - Zip Code:33037-3207
Practice Address - Country:US
Practice Address - Phone:305-453-5382
Practice Address - Fax:305-453-5382
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-07
Last Update Date:2012-12-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WV08411207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV08411OtherWEST VIRGINIA BOARD OF MEDICINE