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Organization
WELLSPAN MEDICAL GROUP
Active
Organization
WELLSPAN MEDICAL GROUP
Active
Other names
WELLSPAN FAMILY MEDICINE - HERR'S RIDGE
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHRISTINA VEST (CREDENTIALING SUPERVISOR)
(717) 851-1405
Entity
Organization
Contact information
Practice address
820 CHAMBERSBURG RD, GETTYSBURG, PA 17325-3310
(717) 337-4410
(717) 337-4411
Mailing address
1803 MOUNT ROSE AVE, SUITE B3, YORK, PA 17403-3051
(717) 851-1405
(717) 337-4411
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03273300
CAPITAL BLUE CROSS
PA
01
—
0404995001
AMERIHEALTH 65 PA
PA
05
—
1007721360127
—
PA
01
—
130452
UNISON
PA
01
—
1382344
HIGHMARK BLUE SHIELD
PA
01
—
1520445
GATEWAY
PA
01
—
20013070
AMERIHEALTH MERCY
PA
01
—
401065502
MD MEDICAL ASSISTANCE
MD
01
—
7865863
AETNA
PA
01
—
800174
JOHN HOPKINS
PA
01
—
CA3246
RAILROAD MEDICARE
PA
01
—
KX10
CAREFIRST MD BCBS
MD
01
—
S1FB
GEISINGER
PA
Enumeration date
12/01/2006
Last updated
01/11/2018
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