MEDICARE: WELLSPAN MEDICAL GROUP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	202D00000X	Integrative Medicine Physician
2	207Q00000X	Family Medicine Physician
3	363A00000X	Physician Assistant
4	363L00000X	Nurse Practitioner
5	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1073315958
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELLSPAN MEDICAL GROUP

Provider Business Mailing Address
First Line	:	601 MEMORY LN
Second Line	:
City	:	YORK
State	:	PA
Zip	:	17402-2231
Country	:	US
Telephone Number	:	717-851-1405
Fax Number	:

Provider Business Practice Location Address
First Line	:	7055 WESTBRANCH HWY
Second Line	:
City	:	LEWISBURG
State	:	PA
Zip	:	17837-6808
Country	:	US
Telephone Number	:	570-524-4141
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	JENNIFER SWEITZER
Credential	:
Telephone Number	:	717-851-6838

Provider Enumeration Date	:	03/24/2025
Last Update Date	:	03/24/2025

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Directions to “WELLSPAN MEDICAL GROUP ” Practice Location

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