Provider Demographics
NPI:1336917335
Name:WELLS, RAUHEEM ISAIAH
Entity type:Individual
Prefix:
First Name:RAUHEEM
Middle Name:ISAIAH
Last Name:WELLS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4831 TOWNSEND DR
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-7683
Mailing Address - Country:US
Mailing Address - Phone:419-708-3874
Mailing Address - Fax:
Practice Address - Street 1:4831 TOWNSEND DR
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-7683
Practice Address - Country:US
Practice Address - Phone:419-708-3874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-19
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty