Wells Ave Clinic

NPI #1215320304 in Reno, Nevada

Provider Information

NPI Number: 1215320304
Entity Type: Organization
Organization Name: Wells Ave Clinic
Primary Specialty: Internal Medicine
Enumeration Date: Mar 12, 2015
Last Updated: Mar 12, 2015

Practice Location

Address: 1255 S WELLS AVE
City: Reno
State: Nevada
ZIP Code: 89502-2504
Phone: (775) 284-5004

Authorized Official

Name: VIDUR SIDDHANTH MAHADEVA, M.D.
Title: SOLE OWNER
Phone: (775) 247-2917

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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