| Wellway Medical P.a. | |
|
2905 Northwest Blvd Ste 230 Plymouth MN 55441-2644 | |
| (612) 367-4824 | |
| Not Available |
| Full Name | Wellway Medical P.a. |
|---|---|
| Speciality | Internal Medicine |
| Location | 2905 Northwest Blvd Ste 230, Plymouth, Minnesota |
| Authorized Official Name and Position | Susan Echt Ritter (OWNER) |
| Authorized Official Contact | 3032298345 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellway Medical P.a. 2905 Northwest Blvd Ste 230 Plymouth MN 55441-2644 Ph: (612) 367-4824 | Wellway Medical P.a. 2905 Northwest Blvd Ste 230 Plymouth MN 55441-2644 Ph: (612) 367-4824 |
| NPI Number | 1063170785 |
|---|---|
| Provider Enumeration Date | 11/30/2021 |
| Last Update Date | 11/30/2021 |
| Medicare PECOS PAC ID | 1456734714 |
|---|---|
| Medicare Enrollment ID | O20220818002547 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063170785 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Lauren A Schultheis |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1073145538 PECOS PAC ID: 9830516459 Enrollment ID: I20200827002883 |
| Provider Name | Jacob T Webber |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1881292878 PECOS PAC ID: 6608286729 Enrollment ID: I20201031000077 |
| Provider Name | Susan Michelle Echt |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1235441205 PECOS PAC ID: 2961645585 Enrollment ID: I20220826000080 |
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