Provider Demographics
NPI:1558335257
Name:WELCH, CHARLES ALFRED (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:ALFRED
Last Name:WELCH
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Gender:M
Credentials:MD
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Mailing Address - Street 1:56 SHEPARD ST
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-1523
Mailing Address - Country:US
Mailing Address - Phone:617-347-7011
Mailing Address - Fax:617-945-0991
Practice Address - Street 1:56 SHEPARD ST
Practice Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-1523
Practice Address - Country:US
Practice Address - Phone:617-347-7011
Practice Address - Fax:617-945-0991
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-17
Last Update Date:2015-02-02
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Provider Licenses
StateLicense IDTaxonomies
MA358532084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA700917OtherTUFTS HEALTH PLAN
MAB06016OtherBCBS MA
MA2006278Medicaid
MAB06016OtherBCBS MA
MA2006278Medicaid