| Wellspring Family Practice, Pa | |
|
81 Medical Park Loop Suite 202 Sylva NC 28779-5291 | |
| (828) 586-7705 | |
| (828) 586-7714 |
| Full Name | Wellspring Family Practice, Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 81 Medical Park Loop, Sylva, North Carolina |
| Authorized Official Name and Position | Matthew Alan Mahar (OWNER) |
| Authorized Official Contact | 8285867705 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellspring Family Practice, Pa Po Box 149 Sylva NC 28779-0149 Ph: (828) 586-7705 | Wellspring Family Practice, Pa 81 Medical Park Loop Suite 202 Sylva NC 28779-5291 Ph: (828) 586-7705 |
| NPI Number | 1083756761 |
|---|---|
| Provider Enumeration Date | 02/12/2007 |
| Last Update Date | 08/07/2013 |
| Medicare PECOS PAC ID | 0941249312 |
|---|---|
| Medicare Enrollment ID | O20050426001100 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083756761 | NPI | - | NPPES |
| 5950037 | Medicaid | NC | |
| 019U1 | Other | NC | BCBS-GROUP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 200001199 (North Carolina) | Primary |
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