1982778189 NPI number — MICHAEL WELTHER

Table of content: (NPI 1982778189)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982778189 NPI number — MICHAEL WELTHER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MICHAEL WELTHER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ARLINGTON FAMILY PRACTICE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1982778189
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/28/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 690
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ARLINGTON
Provider Business Mailing Address State Name:
VT
Provider Business Mailing Address Postal Code:
05250-0690
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
802-375-6566
Provider Business Mailing Address Fax Number:
802-375-6828

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9 CHURCH STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARLINGTON
Provider Business Practice Location Address State Name:
VT
Provider Business Practice Location Address Postal Code:
05250
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
802-375-6566
Provider Business Practice Location Address Fax Number:
802-375-6828
Provider Enumeration Date:
11/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WELTHER
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
J
Authorized Official Title or Position:
OWNER PROPRIETOR
Authorized Official Telephone Number:
802-375-6566

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 41490 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 473830 . This is a "MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8000107 . This is a "LADIES FIRST" identifier . This identifiers is of the category "OTHER".
  • Identifier: WELT00007333 . This is a "VT BLUE CROSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0473830 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".
  • Identifier: WEV9138 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00473830 . This is a "VERMONT BLUE CROSS" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".




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