Provider Demographics
NPI:1134234859
Name:WELLS, ALVIN F (MD)
Entity type:Individual
Prefix:DR
First Name:ALVIN
Middle Name:F
Last Name:WELLS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:917 MAR WALT DR
Mailing Address - Street 2:
Mailing Address - City:FORT WALTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32547-6651
Mailing Address - Country:US
Mailing Address - Phone:850-862-3979
Mailing Address - Fax:850-862-0605
Practice Address - Street 1:137 CRYSTAL BEACH DR STE 121
Practice Address - Street 2:
Practice Address - City:DESTIN
Practice Address - State:FL
Practice Address - Zip Code:32541-3573
Practice Address - Country:US
Practice Address - Phone:850-807-4388
Practice Address - Fax:850-862-3979
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2024-08-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI46013207RR0500X
FLME169775207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI000001437Medicare PIN
WIG90894Medicare UPIN