Organization
WELLSPRING CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NKIRUKA ARENE M.D. (DIRECTOR)
(443) 371-9750
Entity
Organization
Contact information
Practice address
2012 S TOLLGATE RD STE 207, BEL AIR, MD 21015-5902
(443) 371-9750
(443) 371-9751
Mailing address
2012 S TOLLGATE RD STE 207, BEL AIR, MD 21015-5902
(443) 371-9750
(443) 371-9751
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
2081P0301X
Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
—
261QM2500X
Medical Specialty Clinic/Center
D63924
MD
Other
Enumeration date
10/30/2012
Last updated
11/27/2023
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