Provider Demographics
NPI:1699950147
Name:WELLS, RONDA LYNN (MD)
Entity type:Individual
Prefix:
First Name:RONDA
Middle Name:LYNN
Last Name:WELLS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8417 CAMPBELL CT
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46158-7720
Mailing Address - Country:US
Mailing Address - Phone:317-831-8712
Mailing Address - Fax:
Practice Address - Street 1:8417 CAMPBELL CT
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46158-7720
Practice Address - Country:US
Practice Address - Phone:317-831-8712
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-03
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01032003A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine