Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | D13796 | MN |
NPI | 1033477492 |
---|---|
Provider Name | Dr. Sean Philip Welander |
First Address | Saint Cloud, MN 56303-3424 |
Second Address | Saint Cloud, MN 56303-3424 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2012 |
Last Update Date | 28/06/2017 |