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Individual

CHARLES W. WELLY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
5 W BACK ST STE 101, FINCASTLE, VA 24090-4368
(540) 769-3964
(540) 473-3458
Mailing address
PO BOX 8310, ROANOKE, VA 24014-0310
(540) 345-3556
(540) 342-2193

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0102204907
VA
207Q00000X
Family Medicine Physician
2248
AZ

Other

Enumeration date
11/09/2006
Last updated
08/17/2021
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