Provider Demographics
NPI:1124047964
Name:WELSHANS, C ROBERT (OD)
Entity type:Individual
Prefix:DR
First Name:C
Middle Name:ROBERT
Last Name:WELSHANS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:DR
Other - First Name:CHARLES
Other - Middle Name:ROBERT
Other - Last Name:WELSHANS
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2014 DUDLEY AVE
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26101-3405
Mailing Address - Country:US
Mailing Address - Phone:304-422-1841
Mailing Address - Fax:304-865-0592
Practice Address - Street 1:2014 DUDLEY AVE
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-3405
Practice Address - Country:US
Practice Address - Phone:304-422-1841
Practice Address - Fax:304-865-0592
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV838OD152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0149331000Medicaid
WVT32442Medicare UPIN
WV0149331000Medicaid
WV410048338Medicare PIN