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1801954276

NPI Code Detail

MEDICARE: WELLSPAN MEDICAL GROUP

MEDICARE: WELLSPAN MEDICAL GROUP

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	CA3246	OTHER	PA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0021280001	OTHER	PA	AMERIHEALTH 65 PA
2	02293500	OTHER	PA	CAPITAL BLUE CROSS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	84533	OTHER	PA	UNISON
5	1142430	OTHER	PA	AMERIHEALTH MERCY
7	369120	OTHER	PA	HIGHMARK BLUE SHIELD
8	800174	OTHER	PA	JOHN HOPKINS
9	KX54	OTHER	MD	CAREFIRST MD BCBS
10	S1EZ	OTHER	PA	GEISINGER
11	1519314	OTHER	PA	GATEWAY
12	5894771	OTHER	PA	AETNA

General Provider Information

NPI Number	:	1801954276
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELLSPAN MEDICAL GROUP

Provider Business Mailing Address
First Line	:	1803 MOUNT ROSE AVE
Second Line	:	SUITE B3
City	:	YORK
State	:	PA
Zip	:	17403-3051
Country	:	US
Telephone Number	:	717-851-1405
Fax Number	:	717-851-6577

Provider Business Practice Location Address
First Line	:	296 ST. CHARLES WAY
Second Line	:
City	:	YORK
State	:	PA
Zip	:	17402-4648
Country	:	US
Telephone Number	:	717-851-6567
Fax Number	:	717-851-6577

Authorized Official
Title or Position	:	CREDENTIALING COORDINATOR
Name	:	MS. AMY F WILKINSON
Credential	:
Telephone Number	:	717-851-1405

Provider Enumeration Date	:	12/05/2006
Last Update Date	:	08/11/2010

Similar Medicare Providers

1407916018 — WELLSPAN MEDICAL GROUP
Practice Location Address:

292 SAINT CHARLES WAY
YORK, PA
17402-4648

Practice Phone: 717-851-6236
Practice Fax: 717-851-6243

1841885019 — MISS HEATHER SERRANO FINK PA-C
Practice Location Address:

292 SAINT CHARLES WAY
YORK, PA
17402-4648

Practice Phone: 717-356-6065
Practice Fax: 717-812-6024

1659356814 — DR. NANCY NKANSAH-MAHANEY MD
Practice Location Address:

296 SAINT CHARLES WAY
YORK, PA
17402-4648

Practice Phone: 717-812-5050
Practice Fax: 717-741-2427

1922050079 — DR. SUNITA GOYLE RAY MD
Practice Location Address:

292 SAINT CHARLES WAY
YORK, PA
17402-4648

Practice Phone: 717-851-6040
Practice Fax: 717-461-7122

1316984271 — DR. JOYCE KOPICKY BURD M.D.
Practice Location Address:

292 SAINT CHARLES WAY
YORK, PA
17402-4648

Practice Phone: 717-851-6236
Practice Fax: 717-851-6243

1013944651 — DR. ARUNA CHELLIAH MD
Practice Location Address:

292 SAINT CHARLES WAY
YORK, PA
17402-4648

Practice Phone: 717-851-6231
Practice Fax: 717-741-1719

Directions to “WELLSPAN MEDICAL GROUP ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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