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General NPI Number Information
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NPI Number | 1730895087
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Entity Type | Organization
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Legal Business Name | WELLSPAN MEDICAL GROUP
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Dates
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Enumeration Date | 01/30/2023
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Last Update Date | 05/06/2024
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Provider Practice Location Address
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Address Line | 12 ST PAUL DR STE 204
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City | CHAMBERSBURG
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State | PA
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Zip | 17201-1035
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Country | US
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Telephone | 717-217-6886
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Fax | 717-217-6896
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Provider Business Mailing Address
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Address Line | 601 MEMORY LN
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City | YORK
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State | PA
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Zip | 17402-2231
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Country | US
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Telephone | 717-851-1405
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Fax | 717-851-6969
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Authorized Official
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Title or Position | DIRECTOR AND AO
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Name | JENNIFER SWEITZER
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Credential |
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Telephone | 717-851-6838
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number |
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License Number State |
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