Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 46013 | WI |
NPI | 1134234859 |
---|---|
Provider Name | Dr. Alvin F Wells |
First Address | Franklin, WI 53132 |
Second Address | Franklin, WI 53132 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2006 |
Last Update Date | 23/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G90894 | (02) | WI |