Organization
WELLSPAN MEDICAL GROUP
Active
Organization
WELLSPAN MEDICAL GROUP
Active
Other names
Wellspan Infectious Disease Specialists
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA MOON (SUPERVISOR-VERIFICATION SERVICES)
(717) 851-1405
Entity
Organization
Contact information
Practice address
1001 S GEORGE ST, MKB 4TH FLOOR, YORK, PA 17403-3676
(717) 851-2417
(717) 851-3712
Mailing address
601 MEMORY LN, YORK, PA 17402-2231
(717) 851-1405
(717) 851-6969
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0667146000
AMERIHEALTH 65 PA
PA
05
—
1007721360253
—
PA
01
—
1554376
GATEWAY
PA
01
—
1948539
HIGHMARK
PA
01
—
20055012
AMERIHEALTH MERCY
PA
01
—
388T
GEISINGER
PA
01
—
50059623
CAPITAL BLUE CROSS
PA
01
—
7866894
AETNA
PA
01
—
800174
JOHN HOPKINS
PA
01
—
CA3246
RAILROAD MEDICARE
PA
01
—
KX54
CAREFIRST BCBS
MD
Enumeration date
12/13/2006
Last updated
06/25/2026
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