Wells, Mary T

Wells, Mary T is an individual health care provider with primary practice located at 11035 W Forest Home Ave , Hales Corners WI 53130-2541. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Wells, Mary T can be contacted via phone (414) 425-5660.

Contact Information

Primary practice address
11035 W Forest Home Ave Hales Corners WI 53130-2541
Phone: (414) 425-5660
Fax: (414) 425-9803
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 46213 Wisconsin

Profile Details

NPI number 1740257674
LBN Legal business name Wells, Mary T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 28th, 2006
Last updated Mar 25th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740257674 NPPES
Wisconsin MEDICAID 34463800

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