Provider Demographics
NPI:1245351055
Name:WELCH, TERRENCE D (MD)
Entity type:Individual
Prefix:DR
First Name:TERRENCE
Middle Name:D
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:ONE MEDICAL CENTER DRIVE
Mailing Address - Street 2:DARTMOUTH-HITCHCOCK MEDICAL CENTER
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03756
Mailing Address - Country:US
Mailing Address - Phone:603-650-7840
Mailing Address - Fax:
Practice Address - Street 1:ONE MEDICAL CENTER DRIVE
Practice Address - Street 2:DARTMOUTH-HITCHCOCK MEDICAL CENTER
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03756
Practice Address - Country:US
Practice Address - Phone:603-650-7840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2013-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN104419207RC0000X
MN52405207RC0000X
NH15606207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3077380Medicaid
VT1020718Medicaid
MNP00874901OtherMEDICARE, RAILROAD
MNENROLLEDMedicaid
NH32001490Medicaid
MN060003063Medicare PIN
VT1020718Medicaid
MNENROLLEDMedicaid