Organization
WELLSPRING CARDIAC CARE, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORGE C. SECADA-LOVIO M.D. (OWNER)
(410) 307-1090
Entity
Organization
Contact information
Practice address
110 WEST RD, BUILDING A, SUITE 201, BALTIMORE, MD 21204-2316
(410) 307-1090
(410) 307-1095
Mailing address
10845 PHILADELPHIA RD, WHITE MARSH, MD 21162-1717
(410) 335-0008
(410) 335-1133
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
D0022633
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
414997100
—
MD
01
—
DN2575
RAILROAD MEDICARE
GA
01
—
FKJ0JC
CAREFIRST
MD
01
—
J046
CAREFIRST DC
DC
Enumeration date
08/27/2007
Last updated
10/13/2008
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