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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
3421 CONCORD RD, YORK, PA 17402-9001
(717) 851-2417
(717) 851-3712

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
11/22/2016
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