Individual
DR. EDWIN G WELLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
450 E MAIN ST, REXBURG, ID 83440-2048
(208) 356-3691
Mailing address
450 E MAIN ST, REXBURG, ID 83440-2048
(208) 356-3691
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
M-9498
ID
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
M-9498
ID
Other
Enumeration date
07/12/2006
Last updated
04/15/2020
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