Individual
DR. BAXTER DREW WELLMON II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
97 PROGRESS BLVD, SHIPPENSBURG, PA 17257-9053
(717) 486-4117
Mailing address
97 PROGRESS BLVD, SHIPPENSBURG, PA 17257-9053
(717) 486-4117
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS009662L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01757777
—
PA
Enumeration date
02/07/2007
Last updated
02/14/2013
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