Individual
JASON M. WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 GRESHAM DR, PATHOLOGY DEPARTMENT, NORFOLK, VA 23507-1904
(757) 388-3221
Mailing address
4619 KENNY RD, COLUMBUS, OH 43220-2779
(614) 457-8180
Taxonomy
Speciality
Code
Description
License number
State
207ZC0006X
Clinical Pathology Physician
MT195871
PA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
0101260185
VA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
8566738-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1750517330
—
VA
Enumeration date
06/09/2009
Last updated
06/17/2016
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