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Organization
WELLSPAN MEDICAL GROUP
Active
Organization
WELLSPAN MEDICAL GROUP
Active
Other names
WELLSPAN INTERNAL MEDICINE - DOVER
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHRISTINA VEST (CREDENTIALING SUPERVISOR)
(717) 851-1405
Entity
Organization
Contact information
Practice address
4020 CARLISLE RD, DOVER, PA 17315-3508
(717) 851-6400
(717) 851-6410
Mailing address
1803 MOUNT ROSE AVE, SUITE B3, YORK, PA 17403-3051
(717) 851-6400
(717) 851-6410
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02293900
CAPITAL BLUE CROSS
PA
01
—
0301664001
AMERIHEALTH 65 PA
PA
01
—
066330
HIGHMARK BLUE SHIELD
PA
05
—
1007721360106
—
PA
01
—
1142384
AMERIHEALTH MERCY
PA
01
—
1519815
GATEWAY
PA
01
—
7368911
AETNA
PA
01
—
800174
JOHN HOPKINS
PA
01
—
86448
UNISON
PA
01
—
CA3246
RAILROAD MEDICARE
PA
01
—
KX54
CAREFIRST MD BCBS
MD
01
—
S1EQ
GEISINGER
PA
Enumeration date
11/30/2006
Last updated
01/11/2018
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