# WELLSPRING CLINIC LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962958926
- **Authorized official:** NKIRUKA ARENE MD (PHYSICIAN)
- **Authorized official phone:** (443) 371-9750

## Contact information

- **Practice address:** 2012 S TOLLGATE RD, SUITE 206, BEL AIR, MD 21015-5900
- **Practice address phone:** (443) 371-9750
- **Mailing address:** 2012 S TOLLGATE RD STE 207, BEL AIR, MD 21015-5902
- **Mailing address phone:** (443) 977-9180

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | D63924 | MD | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | D63924 | MD | Yes |

## Other

- **Enumeration date:** 08/30/2016
- **Last updated:** 07/12/2019