Individual
MARK DOUGLAS WELLMAN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PNP
Contact information
Practice address
101 THOREAU ST, CONCORD, MA 01742-2443
(978) 369-9401
Mailing address
4 ROYCE LN, WESTFORD, MA 01886-4015
(978) 692-9078
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
124639
MA
Other
Enumeration date
11/20/2005
Last updated
07/08/2007
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