| Wellfleet Medical Llc | |
|
1124 Professional Dr Ste 500 Dodgeville WI 53533-1176 | |
| (608) 341-6601 | |
| Not Available |
| Full Name | Wellfleet Medical Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1124 Professional Dr Ste 500, Dodgeville, Wisconsin |
| Authorized Official Name and Position | Kenneth Valyo (OWNER) |
| Authorized Official Contact | 6083416601 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellfleet Medical Llc 1124 Professional Dr Ste 500 Dodgeville WI 53533-1176 Ph: (608) 341-6601 | Wellfleet Medical Llc 1124 Professional Dr Ste 500 Dodgeville WI 53533-1176 Ph: (608) 341-6601 |
| NPI Number | 1881446474 |
|---|---|
| Provider Enumeration Date | 04/04/2024 |
| Last Update Date | 04/04/2024 |
| Medicare PECOS PAC ID | 8820439367 |
|---|---|
| Medicare Enrollment ID | O20240515000155 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881446474 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Kenneth A Valyo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902863632 PECOS PAC ID: 2062469075 Enrollment ID: I20050401000487 |
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