| Wellspring Family Medicine | |
|
311 N 4th St Oakland MD 21550-1371 | |
| (301) 334-7855 | |
| (301) 334-7828 |
| Full Name | Wellspring Family Medicine |
|---|---|
| Speciality | Psychologist |
| Location | 311 N 4th St, Oakland, Maryland |
| Authorized Official Name and Position | Ramona Thomas (OPERATIONS MANAGER) |
| Authorized Official Contact | 3015015110 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellspring Family Medicine 311 N 4th St Oakland MD 21550-1371 Ph: (301) 334-7855 | Wellspring Family Medicine 311 N 4th St Oakland MD 21550-1371 Ph: (301) 334-7855 |
| NPI Number | 1265952998 |
|---|---|
| Provider Enumeration Date | 06/23/2017 |
| Last Update Date | 07/21/2022 |
| Certification Date | 04/07/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265952998 | NPI | - | NPPES |
| 413901100 | Medicaid | MD | |
| 3810006442 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 05746 (Maryland) | Primary |
| 1041C0700X | Social Worker - Clinical | 12014 (Maryland) | Secondary |
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