Organization
WELLSPRING CLINIC LLC
Active
Organization
WELLSPRING CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NKIRUKA ARENE MD (PHYSICIAN)
(443) 371-9750
Entity
Organization
Contact information
Practice address
2012 S TOLLGATE RD, SUITE 206, BEL AIR, MD 21015-5900
(443) 371-9750
Mailing address
2012 S TOLLGATE RD STE 207, BEL AIR, MD 21015-5902
(443) 977-9180
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
D63924
MD
208100000X
Physical Medicine & Rehabilitation Physician
Primary
D63924
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
875800000
—
MD
Enumeration date
08/30/2016
Last updated
07/12/2019
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