Provider Demographics
NPI:1962663237
Name:WELCH, TYLER P (MD)
Entity Type:Individual
Prefix:
First Name:TYLER
Middle Name:P
Last Name:WELCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1900 LAFAYETTE RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-5679
Mailing Address - Country:US
Mailing Address - Phone:603-431-1121
Mailing Address - Fax:603-431-9147
Practice Address - Street 1:1900 LAFAYETTE RD
Practice Address - Street 2:SUITE A
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-5679
Practice Address - Country:US
Practice Address - Phone:603-431-1121
Practice Address - Fax:603-431-9147
Is Sole Proprietor?:No
Enumeration Date:2008-06-19
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA131725207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine