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Organization
WELLSPAN MEDICAL GROUP
Active
Organization
WELLSPAN MEDICAL GROUP
Active
Other names
WellSpan Family Medicine - ELCO
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA MOON (SUPERVISOR-VERIFICATION SERVICES)
(717) 851-1405
Entity
Organization
Contact information
Practice address
6 PERRI AVE, MYERSTOWN, PA 17067-3200
(717) 949-6581
(717) 949-2816
Mailing address
3421 CONCORD RD, YORK, PA 17402-9001
(717) 851-1405
(717) 851-6969
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
Other
Enumeration date
10/19/2016
Last updated
10/19/2016
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