| Wellford Medicine, Llc | |
|
102 Astor St Wellford SC 29385-9622 | |
| (864) 439-5338 | |
| (864) 439-4769 |
| Full Name | Wellford Medicine, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 102 Astor St, Wellford, South Carolina |
| Authorized Official Name and Position | Misty Petras (OWNER) |
| Authorized Official Contact | 8644395338 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellford Medicine, Llc 102 Astor St Wellford SC 29385-9622 Ph: (864) 439-5338 | Wellford Medicine, Llc 102 Astor St Wellford SC 29385-9622 Ph: (864) 439-5338 |
| NPI Number | 1407541022 |
|---|---|
| Provider Enumeration Date | 04/10/2023 |
| Last Update Date | 04/12/2023 |
| Medicare PECOS PAC ID | 3870953029 |
|---|---|
| Medicare Enrollment ID | O20230719001871 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407541022 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Misty Childers Petras |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912341470 PECOS PAC ID: 4284973801 Enrollment ID: I20190226002492 |
| Provider Name | Kelsey Elyse Carter Stoker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114587847 PECOS PAC ID: 4587096987 Enrollment ID: I20191122000465 |
Wellford Family Medicine Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 102 Astor St, Wellford, SC 29385 Phone: 864-439-5338 Fax: 864-439-4769 |