Individual
GRACE E MBONDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2250 E MARKET ST, YORK, PA 17402-2857
(717) 851-1566
(717) 812-3950
Mailing address
1803 MOUNT ROSE AVE, SUITE B3, YORK, PA 17403-3026
(717) 851-1405
(717) 812-3950
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
D0075330
MD
207Q00000X
Family Medicine Physician
MD2008-0808
NM
207Q00000X
Family Medicine Physician
Primary
MD446199
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102744032
—
PA
01
—
1612005
GATEWAY
PA
01
—
2719987
HIGHMARK BLUE SHIELD
PA
01
—
30133660
AMERIHEALTH MERCY - CE
PA
01
—
30133661
AMERIHEALTH MERCY - WRC
PA
01
—
418793
UPMC
PA
05
—
59836733
—
NM
Enumeration date
09/13/2006
Last updated
06/19/2015
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