Provider Demographics
NPI:1609280320
Name:JUDY WELCH MD PA
Entity type:Organization
Organization Name:JUDY WELCH MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR. JUDY WELCH
Authorized Official - Prefix:
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:WELCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:207-294-3500
Mailing Address - Street 1:3 EASTVIEW PKWY STE 3
Mailing Address - Street 2:
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072-6701
Mailing Address - Country:US
Mailing Address - Phone:207-294-3500
Mailing Address - Fax:207-283-4207
Practice Address - Street 1:3 EASTVIEW PKWY STE 3
Practice Address - Street 2:
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-6701
Practice Address - Country:US
Practice Address - Phone:207-294-3500
Practice Address - Fax:207-283-4207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-20
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD13627305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEMM5533Medicare PIN