Provider Demographics
NPI:1447251392
Name:WELSH, TAMARA M (MD)
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:M
Last Name:WELSH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:310 WENDELL AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:LEWISTOWN
Mailing Address - State:MT
Mailing Address - Zip Code:59457-2267
Mailing Address - Country:US
Mailing Address - Phone:406-535-1480
Mailing Address - Fax:406-535-1481
Practice Address - Street 1:310 WENDELL AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:LEWISTOWN
Practice Address - State:MT
Practice Address - Zip Code:59457-2267
Practice Address - Country:US
Practice Address - Phone:406-535-1480
Practice Address - Fax:406-535-1481
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MT10601207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0116623Medicaid
MT96426OtherFWC BCBS
MT0116623Medicaid
MT96426OtherFWC BCBS
MT011000266Medicare ID - Type UnspecifiedFWC