Organization
WELLSPAN MEDICAL GROUP
Active
Other names
Gettysburg Surgical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
AMY F WILKINSON (CREDENTIALING SUPERVISOR)
(717) 851-1405
Entity
Organization
Contact information
Practice address
450 S WASHINGTON ST, SUITE C, GETTYSBURG, PA 17325-2500
(717) 339-3110
(717) 339-3108
Mailing address
1803 MOUNT ROSE AVE, SUITE B3, YORK, PA 17403-3026
(717) 851-1405
(717) 339-3108
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
363AS0400X
Surgical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100772136
—
PA
01
—
1538201
GATEWAY-WMG
PA
01
—
20072208
AMERIHEALTH MERCY-WMG
PA
01
—
2016471
HIGHMARK BLUE SHIELD
PA
01
—
232730
UNISON WMG
PA
01
—
50075811
CAPITAL BLUE CROSS WMG
PA
01
—
655T
GEISINGER
PA
01
—
KC94
CAREFIRST MD BCBS
PA
Enumeration date
03/25/2008
Last updated
11/28/2014
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