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Individual

DR. ROBERT G WELLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2801 W KINNICKINNIC RIVER PKWY, SUITE 355, MILWAUKEE, WI 53215-3669
(414) 649-6430
(414) 649-5563
Mailing address
700 S PARK ST, MADISON, WI 53715-1830
(800) 841-4236
(316) 652-0340

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
036.098953
IL
2085R0202X
Diagnostic Radiology Physician
Primary
23901
WI
2085R0202X
Diagnostic Radiology Physician
27019
OK
2085R0202X
Diagnostic Radiology Physician
ME 104663
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036098953
IL
01
202926
GROUP PTAN
IL
05
313-96200
WI
Enumeration date
05/10/2006
Last updated
01/23/2019
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