Individual
BRIAN J WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1920 W 1ST ST, WINSTON SALEM, NC 27104-4220
(336) 716-4479
(336) 716-1317
Mailing address
PO BOX 602658, CHARLOTTE, NC 28260-2658
(336) 716-2011
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2014-01969
NC
207Q00000X
Family Medicine Physician
35084170
OH
Other
Enumeration date
09/28/2006
Last updated
09/12/2016
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