Organization
WELLSPAN MEDICAL GROUP
Active
Other names
Wellspan Plastic Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
AMY F WILKINSON (CREDENTIALING SUPERVISOR)
(717) 851-1401
Entity
Organization
Contact information
Practice address
50 WYNTRE BROOKE DR, YORK, PA 17403-4535
(717) 812-6700
(717) 741-2927
Mailing address
3421 CONCORD RD, YORK, PA 17402-9001
(717) 812-6700
(717) 741-2927
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100772136
—
PA
01
—
1571819
GATEWAY-WMG
PA
01
—
171C
GEISINGER HEALTH PLAN
PA
01
—
20076067
AMERIHEALTH MERCY-WMG
PA
01
—
2047084
HIGHMARK BLUE SHIELD
PA
01
—
50078670
CAPITAL BLUE CROSS-WMG
PA
01
—
9175206
AETNA
PA
01
—
FS72
CAREFIRST MD BCBS
MD
Enumeration date
06/11/2008
Last updated
07/28/2014
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