Wellspring Family Medicine, Pa | |
110 Atrium Way Columbia SC 29223-6301 | |
(803) 865-9655 | |
(803) 865-9653 |
Full Name | Wellspring Family Medicine, Pa |
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Speciality | Family Medicine |
Location | 110 Atrium Way, Columbia, South Carolina |
Authorized Official Name and Position | Damon Daniels (MEDICAL DOCTOR) |
Authorized Official Contact | 8038659655 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Wellspring Family Medicine, Pa 110 Atrium Way Columbia SC 29223-6301 Ph: (803) 865-9655 | Wellspring Family Medicine, Pa 110 Atrium Way Columbia SC 29223-6301 Ph: (803) 865-9655 |
NPI Number | 1871718445 |
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Provider Enumeration Date | 04/17/2007 |
Last Update Date | 08/30/2013 |
Medicare PECOS PAC ID | 6709987860 |
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Medicare Enrollment ID | O20070719000807 |
Identifier | Type | State | Issuer |
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1871718445 | NPI | - | NPPES |
218231 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | 21823 (South Carolina) | Primary |
Provider Name | Damon Daniels |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1235104464 PECOS PAC ID: 2860593910 Enrollment ID: I20070719000631 |
Provider Name | La Tonya Nicole Brown |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1023064920 PECOS PAC ID: 4183899883 Enrollment ID: I20111207000891 |
Northlake Family Medical Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3000 Ne Medical Park, Ste 101, Columbia, SC 29223 Phone: 803-419-5131 Fax: 803-419-5130 | |
Lagniappe Medical Clinics, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 74 Polo Rd, Columbia, SC 29223 Phone: 803-419-7780 Fax: 803-419-7781 | |