Healthcare Provider Details

I. General information

NPI: 1104740059
Provider Name (Legal Business Name): LANCASTER GENERAL MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

538 N QUEEN ST STE 320
LANCASTER PA
17603-3046
US

IV. Provider business mailing address

555 N DUKE ST
LANCASTER PA
17602-2250
US

V. Phone/Fax

Practice location:
  • Phone: 717-290-3300
  • Fax: 717-290-3301
Mailing address:
  • Phone: 717-544-7279
  • Fax: 717-544-4296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: GARY WELCH
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 717-544-5658