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Individual

ANASTASIA H WELLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
709 SPRING VALLEY RD, BURLINGTON, WI 53105-7614
(262) 767-6020
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
65421
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1235130782
WI
05
1482811
LA
01
K400298694
MEDICARE
WI
Enumeration date
08/09/2005
Last updated
03/14/2024
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