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1922021401
KEIVER T WELCH
BANGOR, ME
NPI
1922021401
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: ME PA-170)
Enumeration Date
2006-07-25
Last Update Date
2022-02-03
Business Address
KEIVER T WELCH PA
360 BROADWAY
BANGOR, ME 04401-3900
Phone number: 207-907-3650
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Mailing Address
KEIVER T WELCH PA
C/O ST MARYS HEALTH SYSTEM - PROVIDER ENROLLMENT PO BOX 7291
LEWISTON, ME 04243-7291
Phone number: 207-777-8941
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