Wellspan Medical Group

NPI #1588114094 in Ephrata, Pennsylvania

Provider Information

NPI Number: 1588114094
Entity Type: Organization
Organization Name: Wellspan Medical Group
Primary Specialty: Family Medicine
Enumeration Date: Oct 7, 2016
Last Updated: Oct 7, 2016

Practice Location

Address: 136 LAKE ST
City: Ephrata
State: Pennsylvania
ZIP Code: 17522-2415
Phone: (717) 721-7718

Authorized Official

Name: CHRISTINA MOON
Title: SUPERVISOR-VERIFICATION SERVICES
Phone: (717) 851-1405

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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