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Individual
RENE L WELLS
Active
Individual
RENE L WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
OA002592
PA
363A00000X
Physician Assistant
Primary
MA051791
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018251700002
—
PA
01
—
2078210
BLUE SHIELD
PA
01
—
61854
GEISINGER
PA
01
—
V0075D
UPMC
PA
Enumeration date
11/21/2006
Last updated
04/06/2011
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