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Organization
NORTHERN LANCASTER COUNTY MEDICAL GROUP
Active
Organization
NORTHERN LANCASTER COUNTY MEDICAL GROUP
Active
Other names
Wellspan Family Medicine-Akron
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES DAVID NOLL DO (VICE PRESIDENT)
(717) 859-5161
Entity
Organization
Contact information
Practice address
101 S 7TH ST, AKRON, PA 17501-1329
(717) 859-2112
Mailing address
4131 OREGON PIKE, SUITE C, EPHRATA, PA 17522-9550
(717) 859-5161
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013977730001
—
PA
01
—
1520970
GATEWAY
PA
01
—
1748781
BLUE SHIELD
PA
01
—
2614987
AETNA
PA
01
—
50051114
BLUE CROSS
PA
01
—
DD6938
RAILROAD MEDICARE
PA
Enumeration date
06/02/2006
Last updated
05/05/2015
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