Provider Demographics
NPI:1316731854
Name:WELLINGTON, JAMES WILLIAM (PA)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:WILLIAM
Last Name:WELLINGTON
Suffix:
Gender:
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57607 PAUL
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48094-3835
Mailing Address - Country:US
Mailing Address - Phone:586-747-5511
Mailing Address - Fax:
Practice Address - Street 1:57607 PAUL
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:MI
Practice Address - Zip Code:48094-3835
Practice Address - Country:US
Practice Address - Phone:586-747-5511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-08
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program