Individual
JULIE L. WELTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
211 FOREST ST, MCCALL, ID 83638
(208) 634-2225
(208) 634-7212
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M7311
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010149281
BS
ID
05
—
003994500
—
ID
01
—
B3382
BC
ID
Enumeration date
02/09/2007
Last updated
09/18/2012
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