Organization
MARVIN L WELLS DO PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARVIN WELLS DO (OWNER)
(313) 563-3332
Entity
Organization
Contact information
Practice address
300 ROCK RUN RD, FRIENDLY, WV 26146
(313) 563-3332
(313) 563-3342
Mailing address
300 ROCK RUN RD, FRIENDLY, WV 26146
(313) 563-3332
(313) 563-3342
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110F312140
BLUE SHIELD
MI
01
—
CE8407
RR MEDICARE
MI
Enumeration date
01/25/2007
Last updated
11/22/2010
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