Provider Demographics
NPI:1184862062
Name:WELZANT, VICTOR WILLIAM (PSYD)
Entity type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:WILLIAM
Last Name:WELZANT
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6525 N CHARLES ST
Mailing Address - Street 2:SUITE 135
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-6872
Mailing Address - Country:US
Mailing Address - Phone:443-677-7402
Mailing Address - Fax:
Practice Address - Street 1:6525 N CHARLES ST
Practice Address - Street 2:SUITE 135
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-6872
Practice Address - Country:US
Practice Address - Phone:443-677-7402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-30
Last Update Date:2009-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04570103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical