Provider Demographics
NPI:1285330555
Name:WELTHA, JAMES (PA)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:WELTHA
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 20TH ST NW FRNT 1
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-3411
Mailing Address - Country:US
Mailing Address - Phone:515-450-6905
Mailing Address - Fax:
Practice Address - Street 1:1120 20TH ST NW FRNT 1
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-3411
Practice Address - Country:US
Practice Address - Phone:202-416-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-07
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPA200001672363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical