Provider Demographics
NPI:1982778189
Name:MICHAEL WELTHER
Entity Type:Organization
Organization Name:MICHAEL WELTHER
Other - Org Name:ARLINGTON FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:WELTHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:802-375-6566
Mailing Address - Street 1:PO BOX 690
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05250-0690
Mailing Address - Country:US
Mailing Address - Phone:802-375-6566
Mailing Address - Fax:802-375-6828
Practice Address - Street 1:9 CHURCH STREET
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05250
Practice Address - Country:US
Practice Address - Phone:802-375-6566
Practice Address - Fax:802-375-6828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
41490OtherCIGNA
473830OtherMEDICARE
8000107OtherLADIES FIRST
WELT00007333OtherVT BLUE CROSS
VT0473830Medicaid
VTWEV9138Medicaid
VT00473830OtherVERMONT BLUE CROSS
473830OtherMEDICARE
WELT00007333OtherVT BLUE CROSS
41490OtherCIGNA