Provider Demographics
NPI:1356403331
Name:WELCH, MICHAEL T (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:T
Last Name:WELCH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 954
Mailing Address - Street 2:
Mailing Address - City:SYKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21784-0954
Mailing Address - Country:US
Mailing Address - Phone:443-522-4213
Mailing Address - Fax:
Practice Address - Street 1:1711 YORK RD
Practice Address - Street 2:
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-5613
Practice Address - Country:US
Practice Address - Phone:410-560-1880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS03804111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU94511Medicare UPIN
NYX5U271Medicare ID - Type Unspecified