Provider Demographics
NPI:1760977565
Name:MATOS WELLS, ALEJANDRO (MD)
Entity type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:
Last Name:MATOS WELLS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2314 SASSAFRAS ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16502-2721
Mailing Address - Country:US
Mailing Address - Phone:814-456-6194
Mailing Address - Fax:814-452-5777
Practice Address - Street 1:2314 SASSAFRAS ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16502-2721
Practice Address - Country:US
Practice Address - Phone:814-456-6194
Practice Address - Fax:814-452-5777
Is Sole Proprietor?:No
Enumeration Date:2018-06-25
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD483221207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease