Individual
DR. GLENN WESLEY WELCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
305 ELM ST W, HAMPTON, SC 29924
(803) 943-9007
Mailing address
305 ELM ST W, HAMPTON, SC 29924
(803) 943-9007
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
16263
SC
207Q00000X
Family Medicine Physician
16263
SC
208M00000X
Hospitalist Physician
Primary
16263
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP1756
—
SC
Enumeration date
09/01/2006
Last updated
04/01/2013
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