Organization
WELLSPAN MEDICAL GROUP
Active
Other names
WELLSPAN FAMILY MEDICINE - THURMONT
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHRISTINA VEST (CREDENTIALING SUPERVISOR)
(717) 851-1405
Entity
Organization
Contact information
Practice address
52 WATER ST, THURMONT, MD 21788-1912
(301) 271-3535
(301) 271-2650
Mailing address
1803 MOUNT ROSE AVE, SUITE B3, YORK, PA 17403-3051
(717) 851-1405
(301) 271-2650
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03256300
CAPITAL BLUE CROSS
PA
05
—
1007721360131
—
PA
01
—
132622
UNISON
PA
01
—
1382371
HIGHMARK BLUE SHIELD
PA
01
—
1520447
GATEWAY
PA
01
—
20013086
AMERIHEALTH MERCY
PA
01
—
401065501
MARYLAND MEDICAL ASSISTANCE
MD
05
—
401065501
—
MD
01
—
7185822
AETNA
PA
01
—
800174
JOHN HOPKINS
PA
01
—
CJ8326
RAILROAD
PA
01
—
KX10
CAREFIRST MD BCBS
MD
01
—
S1FD
GEISINGER
PA
Enumeration date
11/30/2006
Last updated
01/11/2018
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