Provider Demographics
NPI:1649658220
Name:WELLING, BENJAMIN DARREL (MD)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:DARREL
Last Name:WELLING
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 1:5110 W BISMARK AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-6775
Mailing Address - Country:US
Mailing Address - Phone:713-775-7695
Mailing Address - Fax:
Practice Address - Street 1:605 E HOLLAND AVE STE 112
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1246
Practice Address - Country:US
Practice Address - Phone:509-342-3251
Practice Address - Fax:509-342-3280
Is Sole Proprietor?:No
Enumeration Date:2015-05-14
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10054323207X00000X
MN67450207XS0106X
WA61114016207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery