Wellspan Medical Group

NPI #1740835560 in York, Pennsylvania

Provider Information

NPI Number: 1740835560
Entity Type: Organization
Organization Name: Wellspan Medical Group
Primary Specialty: Internal Medicine
Enumeration Date: Aug 8, 2019
Last Updated: Aug 8, 2019

Practice Location

Address: 1401 ROOSEVELT AVE
City: York
State: Pennsylvania
ZIP Code: 17404-2244
Phone: (717) 812-4253

Authorized Official

Name: JULIANN DIAZ
Title: SUPERVISOR OF CREDENTIALING
Phone: (717) 851-7134

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X
Internal Medicine	207R00000X	Primary

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