| Wellspace Primary Care Pllc | |
|
65 Walnut St Ste 500 Wellesley MA 02481-2112 | |
| (781) 304-8236 | |
| Not Available |
| Full Name | Wellspace Primary Care Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 65 Walnut St Ste 500, Wellesley, Massachusetts |
| Authorized Official Name and Position | Michael David Dick (FAMILY MEDICINE PHYSICIAN) |
| Authorized Official Contact | 7145533887 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellspace Primary Care Pllc 10 Cumberland Rd Belmont MA 02478-2111 Ph: (714) 553-3887 | Wellspace Primary Care Pllc 65 Walnut St Ste 500 Wellesley MA 02481-2112 Ph: (781) 304-8236 |
| NPI Number | 1104647817 |
|---|---|
| Provider Enumeration Date | 10/24/2024 |
| Last Update Date | 02/13/2025 |
| Medicare PECOS PAC ID | 7911420831 |
|---|---|
| Medicare Enrollment ID | O20250401001035 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104647817 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Michael D Dick |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912345430 PECOS PAC ID: 3476781741 Enrollment ID: I20160901000593 |
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