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Individual

MR. MATTHEW DEAN WELDER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
300 W HOSPITAL RD, FORT GORDON, GA 30905-5741
(706) 787-1910
Mailing address
1054 CONN DR, EVANS, GA 30809-4860
(706) 650-0616

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
102247
IA
367500000X
Certified Registered Nurse Anesthetist
RN187781
GA

Other

Enumeration date
12/16/2006
Last updated
02/08/2008
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