Organization
BRUCE H WELLMON DPM PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE H WELLMON DPM (DPM)
(864) 487-5516
Entity
Organization
Contact information
Practice address
101 PROFESSIONAL PARK, GAFFNEY, SC 29340
(864) 487-5516
(864) 487-3477
Mailing address
PO BOX 1436, GAFFNEY, SC 29342-1436
(864) 487-5516
(864) 487-3477
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
1738
FL
213E00000X
Podiatrist
216
NC
213E00000X
Podiatrist
86
SC
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
86
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8908156
—
NC
01
—
DM0706
MEDICAID DME
SC
05
—
PD0868
—
SC
Enumeration date
08/29/2007
Last updated
08/29/2022
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