Individual
MICHAEL KEASLER WELBORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
115 BRUSHY CREEK RD, EASLEY, SC 29642-1120
(864) 635-0376
(864) 442-6848
Mailing address
PO BOX 1315, EASLEY, SC 29641-1315
(864) 635-0376
(864) 442-6848
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5415
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
054158
—
SC
01
—
582296052-055
BLUE CROSS
SC
Enumeration date
05/15/2006
Last updated
10/13/2021
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