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General NPI Number Information
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NPI Number | 1194744359
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Entity Type | Organization
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Legal Business Name | WELLSPRING FAMILY MEDICINE, PC
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 03/28/2025
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Provider Practice Location Address
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Address Line | 311 N 4TH ST STE 1
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City | OAKLAND
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State | MD
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Zip | 21550-1371
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Country | US
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Telephone | 301-334-7855
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Fax | 833-398-2061
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Provider Business Mailing Address
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Address Line | 311 N 4TH ST SUITE 1
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City | OAKLAND
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State | MD
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Zip | 21550-1395
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Country | US
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Telephone | 301-334-7855
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Fax | 301-334-7828
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Authorized Official
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Title or Position | CFO
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Name | SHAINA SATURDAY
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Credential |
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Telephone | 301-334-7855
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | H0064705
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | D0061801
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | H0064705
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License Number State | MD
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | C0001983
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License Number State | MD
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Taxonomy #5
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | D0061801
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License Number State | MD
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