MEDICARE: WELLSPRING FAMILY MEDICINE, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1295522373
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELLSPRING FAMILY MEDICINE, PC

Provider Business Mailing Address
First Line	:	311 N 4TH ST STE 1
Second Line	:
City	:	OAKLAND
State	:	MD
Zip	:	21550-1371
Country	:	US
Telephone Number	:	301-334-7855
Fax Number	:

Provider Business Practice Location Address
First Line	:	710 N CENTRE ST STE 2001
Second Line	:
City	:	CUMBERLAND
State	:	MD
Zip	:	21502-2107
Country	:	US
Telephone Number	:	301-334-7855
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	SHAINA SATURDAY
Credential	:
Telephone Number	:	301-334-7855

Provider Enumeration Date	:	04/22/2025
Last Update Date	:	04/22/2025

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