Provider Demographics
NPI:1356338909
Name:WELCH, WENDY ANN (MD)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:ANN
Last Name:WELCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 91734
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23291-1734
Mailing Address - Country:US
Mailing Address - Phone:804-358-6100
Mailing Address - Fax:804-342-7619
Practice Address - Street 1:1308 SHERWOOD AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23220
Practice Address - Country:US
Practice Address - Phone:804-828-3129
Practice Address - Fax:804-828-9493
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2018-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012627512084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL260043309OtherRAILROAD MEDICARE
FLME0066677OtherDCWO
FL379436900Medicaid
FLME0066677OtherVOLUSIA HEALTH NETWORK
FL32263OtherBCBS
FLME0066677OtherUNITED BENEFITS
FLME0066677OtherDCWO
FLF42303Medicare UPIN