Wells, Wendell Lee
Wells, Wendell Lee is an sole proprietor health care provider with primary practice located at 1501 Hiland Ave Suite L-1, Burley ID 83318-2682. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Wells, Wendell Lee can be contacted via phone (208) 678-8899.Contact Information
Primary practice address
1501 Hiland Ave Suite L-1
Burley ID 83318-2682
Phone: (208) 678-8899
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | M4248 | Idaho |
Profile Details
| NPI number | 1902848922 |
|---|---|
| LBN Legal business name | Wells, Wendell Lee |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 12th, 2006 |
| Last updated | Oct 18th, 2018 - about 7 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1902848922 | NPPES |
| Idaho | Other | 000010004744 | BLUE SHIELD |
| Idaho | MEDICAID | 002556300 | BLUE SHIELD |
| Idaho | Other | 4248-1 | BLUE SHIELD |
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