Provider Demographics
NPI:1427062652
Name:WELCH, MICHAEL C (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:C
Last Name:WELCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:624 MCCLELLAN STREET
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SCHNECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12304-1020
Mailing Address - Country:US
Mailing Address - Phone:518-382-2260
Mailing Address - Fax:518-347-5007
Practice Address - Street 1:624 MCCLELLAN STREET
Practice Address - Street 2:SUITE 101
Practice Address - City:SCHNECTADY
Practice Address - State:NY
Practice Address - Zip Code:12304-1020
Practice Address - Country:US
Practice Address - Phone:518-382-2260
Practice Address - Fax:518-347-5007
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY131244-1173000000X
NY131244207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00606331Medicaid
NYP00289784OtherRAILROAD MEDICARE
NYDB1987OtherRAILROAD MEDICARE
NYDB1987OtherRAILROAD MEDICARE
NYP00289784OtherRAILROAD MEDICARE
NY00606331Medicaid
NYRB8344Medicare PIN