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Organization
WELLSPAN MEDICAL GROUP
Active
Organization
WELLSPAN MEDICAL GROUP
Active
Other names
WELLSPAN INTERNAL MEDICINE - RED LION
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHRISTINA VEST (CREDENTIALING SUPERVISOR)
(717) 851-1405
Entity
Organization
Contact information
Practice address
3065 WINDSOR RD, RED LION, PA 17356-8533
(717) 851-1700
(717) 851-1710
Mailing address
1803 MOUNT ROSE AVE, SUITE B3, YORK, PA 17403-3051
(717) 851-1405
(717) 851-1710
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0068508002
AMERIHEALTH 65 PA
PA
01
—
02301800
CAPITAL BLUE CROSS
PA
05
—
1007721360093
—
PA
01
—
111191
HIGHMARK BLUE SHIELD
PA
01
—
1142361
AMERIHEALTH MERCY
PA
01
—
1519310
GATEWAY
PA
01
—
4624959
AETNA
PA
01
—
800174
JOHN HOPKINS
PA
01
—
82238
UNISON
PA
01
—
CA3246
RAILROAD MEDICARE
PA
01
—
KX54
CAREFIRST MD BCBS
MD
01
—
S1EU
GEISINGER
PA
Enumeration date
11/30/2006
Last updated
01/11/2018
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