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Organization
NORTHERAN LANCASTER COUNTY MEDICAL GROUP
Active
Organization
NORTHERAN LANCASTER COUNTY MEDICAL GROUP
Active
Other names
Wellspan Internal Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES DAVID NOLL DO (VICE PRESIDENT)
(717) 859-5161
Entity
Organization
Contact information
Practice address
446 N READING RD, SUITE 301, EPHRATA, PA 17522-9802
(717) 733-6546
(717) 733-6011
Mailing address
4131 OREGON PIKE, SUITE C, EPHRATA, PA 17522-9550
(717) 859-5161
(717) 859-5169
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013977730021
—
PA
Enumeration date
07/05/2012
Last updated
05/27/2015
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