Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 35069832 | OH |
Y | 208600000X | Surgeon | 35069832 | OH |
N | 2082S0105X | Plastic Hand Surgeon | 35069832 | OH |
NPI | 1215926597 |
---|---|
Provider Name | Mark D Wells |
First Address | Dublin, OH 43016-4259 |
Second Address | Columbus, OH 43215-4354 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2005 |
Last Update Date | 12/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0237603 | (05) | OH |