Individual
ROBERT STEPHEN WELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
(336) 716-8190
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
(336) 716-8190
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
9701653
NC
207LP2900X
Pain Medicine (Anesthesiology) Physician
9701653
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1068K
BCBS
—
01
—
20893
PARTNERS
—
05
—
220935000
—
WV
01
—
50086563
RR MEDICARE
—
05
—
5712378
—
VA
01
—
5785601
AETNA
—
01
—
74317
MEDCOST
—
05
—
891068K
—
NC
05
—
Q01653
—
SC
Enumeration date
12/13/2005
Last updated
09/11/2017
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