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Organization
WELLSPAN MEDICAL GROUP
Active
Organization
WELLSPAN MEDICAL GROUP
Active
Other names
WellSpan Urgent Care
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHRISTINA MOON (CREDENTIALING SUPERVISOR)
(717) 851-1404
Entity
Organization
Contact information
Practice address
455 S WASHINGTON ST, STE 12, GETTYSBURG, PA 17325-2516
(717) 339-2875
(717) 334-3921
Mailing address
3421 CONCORD RD, YORK, PA 17402-9001
(717) 851-1405
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
363L00000X
Nurse Practitioner
—
—
363LA2100X
Acute Care Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100772136
—
PA
01
—
F561
CAREFIRST MD BCBS
MD
Enumeration date
09/26/2008
Last updated
08/29/2017
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