Individual
CASEY MARK WELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
455 TOLL GATE RD, WARWICK, RI 02886-2759
(405) 737-7010
Mailing address
455 TOLL GATE RD, WARWICK, RI 02886-2759
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
LP05776
RI
Other
Enumeration date
03/22/2022
Last updated
06/20/2022
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