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Organization
WELLSPAN MEDICAL GROUP
Active
Organization
WELLSPAN MEDICAL GROUP
Active
Other names
WELLSPAN FAMILY MEDICINE-BALTIMORE ST
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LAURA FRANK (CREDENTIALING SUPERVISOR)
(717) 851-1405
Entity
Organization
Contact information
Practice address
1227 BALTIMORE ST, HANOVER, PA 17331-4406
(717) 812-5190
(717) 637-2245
Mailing address
1803 MOUNT ROSE AVE STE B3, YORK, PA 17403-3051
(717) 851-1405
(717) 637-2245
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1545712
GATEWAY HEALTH PLAN
PA
01
—
2800588
HIGHMARK BLUE SHIELD
PA
01
—
30142128
AMERIHEALTH MERCY - WMG
PA
01
—
50115587
CAPITAL BLUE CROSS - WMG
PA
01
—
9172984
AETNA
PA
Enumeration date
01/30/2013
Last updated
05/19/2020
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