Organization
WELLSPAN MEDICAL GROUP
Active
Other names
WellSpan Orthopedics-York
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AMY F WILKINSON (CREDENTIALING SUPERVISOR)
(717) 851-1401
Entity
Organization
Contact information
Practice address
25 MONUMENT RD, SUITE 290, YORK, PA 17403-5073
(717) 812-4090
(717) 812-4092
Mailing address
1803 MOUNT ROSE AVE, SUITE B3, YORK, PA 17403-3026
(717) 851-1405
(717) 812-4092
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XX0801X
Orthopaedic Trauma Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100772136
—
PA
01
—
1578892
GATEWAY
PA
01
—
2084822
HIGHMARK BLUE SHIELD
PA
05
—
401065515
—
MD
01
—
42737
GEISINGER HEALTH PLAN
PA
01
—
50083200
CAPITAL BLUE CROSS-WMG
PA
01
—
9729320
AETNA
PA
01
—
DZV3
CAREFIRST MD BCBS
MD
Enumeration date
11/26/2008
Last updated
12/18/2020
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