Provider Demographics
NPI:1134547151
Name:WELCH, KELLEN (MD)
Entity type:Individual
Prefix:DR
First Name:KELLEN
Middle Name:
Last Name:WELCH
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 1:7107 FITCH RD
Mailing Address - Street 2:
Mailing Address - City:OLMSTED TWP
Mailing Address - State:OH
Mailing Address - Zip Code:44138-1203
Mailing Address - Country:US
Mailing Address - Phone:440-829-6432
Mailing Address - Fax:
Practice Address - Street 1:55 ARCH ST STE 2A
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44304-1424
Practice Address - Country:US
Practice Address - Phone:330-434-5978
Practice Address - Fax:330-434-6908
Is Sole Proprietor?:No
Enumeration Date:2014-04-07
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.136434208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery