Provider Demographics
NPI:1841272895
Name:WELCH, PRISCILLA L (MD)
Entity type:Individual
Prefix:MS
First Name:PRISCILLA
Middle Name:L
Last Name:WELCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8906 TWO NOTCH RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-6366
Mailing Address - Country:US
Mailing Address - Phone:803-254-3676
Mailing Address - Fax:803-254-3678
Practice Address - Street 1:1523 HERITAGE LN
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29505-3197
Practice Address - Country:US
Practice Address - Phone:843-673-9992
Practice Address - Fax:843-673-9996
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2024-04-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SC13928207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCTL5140Medicaid
SCRHC 180Medicaid
SCRHC 180Medicaid
SCD17709Medicare UPIN
SC423802Medicare Oscar/Certification