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Individual

DR. ROBERT CHARLES WELLIVER JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
23 HACKETT BLVD, ALBANY, NY 12208-3436
(518) 262-3341
(518) 262-6660
Mailing address
711 TROY SCHENECTADY RD, SUITE 203, LATHAM, NY 12110-2442
(518) 782-3700
(518) 782-3799

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
036-133090
IL
208800000X
Urology Physician
Primary
274981
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036133090
IL
05
03940636
NY
Enumeration date
06/09/2008
Last updated
01/06/2015
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