| Wellspring Clinic Llc | |
|
2012 S Tollgate Rd Suite 206 Bel Air MD 21015-5900 | |
| (443) 371-9750 | |
| Not Available |
| Full Name | Wellspring Clinic Llc |
|---|---|
| Speciality | Physical Medicine & Rehabilitation |
| Location | 2012 S Tollgate Rd, Bel Air, Maryland |
| Authorized Official Name and Position | Nkiruka Arene (PHYSICIAN) |
| Authorized Official Contact | 4433719750 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellspring Clinic Llc 2012 S Tollgate Rd Ste 207 Bel Air MD 21015-5902 Ph: (443) 977-9180 | Wellspring Clinic Llc 2012 S Tollgate Rd Suite 206 Bel Air MD 21015-5900 Ph: (443) 371-9750 |
| NPI Number | 1962958926 |
|---|---|
| Provider Enumeration Date | 08/30/2016 |
| Last Update Date | 07/12/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962958926 | NPI | - | NPPES |
| 875800000 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | D63924 (Maryland) | Secondary |
| 208100000X | Physical Medicine & Rehabilitation | D63924 (Maryland) | Primary |
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