Organization
WELLSPRING FAMILY MEDICINE, PC
Active
Other names
Wellspring family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
RAMONA THOMAS (OPERATIONS MANAGER)
(301) 501-5110
Entity
Organization
Contact information
Practice address
311 N 4TH ST, OAKLAND, MD 21550-1371
(301) 334-7855
(301) 334-7828
Mailing address
311 N 4TH ST, OAKLAND, MD 21550-1371
(301) 334-7855
(301) 334-7828
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
05746
MD
1041C0700X
Clinical Social Worker
12014
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810006442
—
WV
05
—
413901100
—
MD
Enumeration date
06/23/2017
Last updated
07/21/2022
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