Provider Demographics
NPI:1154687804
Name:WELLER, ANDREW EVERETT (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:EVERETT
Last Name:WELLER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:833 CHESTNUT ST STE 210
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4405
Mailing Address - Country:US
Mailing Address - Phone:215-955-9823
Mailing Address - Fax:215-503-6116
Practice Address - Street 1:3401 CIVIC CENTER BLVD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4319
Practice Address - Country:US
Practice Address - Phone:215-590-7555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-06
Last Update Date:2024-09-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD4528822084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry