Basic Information
Provider Information
NPI: 1235490996
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WELCH
FirstName: ADAM
MiddleName: CHRISTOPHER
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3131 NEWMARK DR STE 220
Address2:  
City: MIAMISBURG
State: OH
PostalCode: 453425400
CountryCode: US
TelephoneNumber: 9374364658
FaxNumber: 9374364984
Practice Location
Address1: 3535 SOUTHERN BLVD
Address2:  
City: KETTERING
State: OH
PostalCode: 454291221
CountryCode: US
TelephoneNumber: 9373958166
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/30/2012
LastUpdateDate: 05/06/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/06/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X35.125381OHN Allopathic & Osteopathic PhysiciansFamily Medicine 
207P00000X35.125381OHY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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