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Individual
ROY WELLS JR.
Active
Individual
ROY WELLS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0550030649
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0002358
—
VT
01
—
00049928
BCBS
VT
Enumeration date
08/11/2005
Last updated
10/15/2007
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