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General NPI Number Information
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NPI Number | 1871718445
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Entity Type | Organization
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Legal Business Name | WELLSPRING FAMILY MEDICINE, PA
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 110 ATRIUM WAY
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City | COLUMBIA
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State | SC
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Zip | 29223-6301
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Country | US
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Telephone | 803-865-9655
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Fax | 803-865-9653
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Provider Business Mailing Address
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Address Line | 74 POLO RD
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City | COLUMBIA
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State | SC
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Zip | 29223-2806
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Country | US
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Telephone | 803-865-9655
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Fax | 803-865-9653
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | DR. DAMON DANIELS
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Credential | MD
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Telephone | 803-865-9655
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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 | 21823
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License Number State | SC
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