Basic Information
| Provider Information | |||||||||
| NPI: | 1316191174 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WELLS | ||||||||
| FirstName: | CHESLEY | ||||||||
| MiddleName: | ELLEN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 27128 | ||||||||
| Address2: | |||||||||
| City: | SALT LAKE CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841270128 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8015074384 | ||||||||
| FaxNumber: | 8015074398 | ||||||||
| Practice Location | |||||||||
| Address1: | 5121 COTTONWOOD ST | ||||||||
| Address2: | HOSPITALISTS | ||||||||
| City: | MURRAY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841077000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8015074384 | ||||||||
| FaxNumber: | 8015074398 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/06/2008 | ||||||||
| LastUpdateDate: | 06/30/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 7471285-1205 | UT | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 7471285-1205 | UT | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.