Organization
WELLSPAN MEDICAL GROUP
Active
Other names
Wellspan Surgical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AMY F WILKINSON (CREDENTIALING COODINATOR)
(717) 851-1405
Entity
Organization
Contact information
Practice address
1601 S QUEEN ST, YORK, PA 17403-4630
(717) 851-6110
(717) 848-2074
Mailing address
1803 MOUNT ROSE AVE, SUITE B3, YORK, PA 17403-3051
(717) 851-1405
(717) 851-1999
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
2086S0102X
Surgical Critical Care Physician
—
—
2086S0127X
Trauma Surgery Physician
—
—
2086S0129X
Vascular Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02321100
CAPITAL BLUE CROSS
PA
01
—
0667146000
AMERIHEALTH 65PA
PA
05
—
1007721360135
—
PA
01
—
117038
HIGHMARK WELLSPAN MG
PA
01
—
118975
UNISON WELLSPAN MG
PA
01
—
20010753
AMERIHEALTH MERCY
PA
01
—
331T
GEISINGER
PA
05
—
401065510
—
MD
01
—
7931883
AETNA
PA
01
—
800174
JOHN HOPKINS WELLSPAN MG
PA
01
—
CA3246
RAILROAD MEDICARE
PA
01
—
D83N
CAREFIRST MD BCBS-WMG
MD
Enumeration date
09/20/2006
Last updated
12/23/2015
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