Individual
MARY JO ELINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
35 MONUMENT RD, SUITE 201, YORK, PA 17403-5074
(717) 812-4083
(717) 812-2244
Mailing address
3421 CONCORD RD, YORK, PA 17402-9001
(717) 812-4083
(717) 812-2244
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
043603
GA
2085R0202X
Diagnostic Radiology Physician
Primary
OS005976L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000869514C
—
GA
05
—
035832100
—
MD
05
—
102451961
—
PA
01
—
1588746
GATEWAY-WMG
PA
01
—
2502433
HIGHMARK BLUE SHIELD
PA
01
—
30075311
AMERIHEALTH MERCY-WMG
PA
01
—
301200
UNISON-WMG
PA
01
—
751227
UPMC-WMG
PA
01
—
919374
CAREFIRST BCBS
MD
Enumeration date
12/21/2005
Last updated
06/30/2016
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