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Organization
WELLSPAN MEDICAL GROUP
Active
Organization
WELLSPAN MEDICAL GROUP
Active
Other names
WELLSPAN FAMILY MEDICINE - STONEBRIDGE
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA FRANK (MANAGER-CVS)
(717) 851-1405
Entity
Organization
Contact information
Practice address
13515 WOLFE RD, SUITE C, NEW FREEDOM, PA 17349-9346
(717) 812-2501
(717) 461-7178
Mailing address
3421 CONCORD RD, YORK, PA 17402-9001
(717) 851-1405
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02298200
CAPITAL BLUE CROSS
PA
01
—
0756543002
AMERIHEALTH 65 PA
PA
05
—
1007721360114
—
PA
01
—
1142414
AMERIHEALTH MERCY
PA
01
—
1519303
GATEWAY
PA
01
—
5551045
AETNA
PA
01
—
596398
HIGHMARK BLUE SHIELD
PA
01
—
800174
JOHN HOPKINS
PA
01
—
82204
UNISON
PA
01
—
CA3246
RAILROAD MEDICARE
PA
01
—
KX10
CAREFIRST MD BCBS
MD
01
—
S1E1
GEISINGER
PA
Enumeration date
11/30/2006
Last updated
10/27/2021
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