| NPI | 1316076961 |
|---|---|
| Doing Business As | WELLSPAN FAMILY MEDICINE - NORTH FOURTH STREET |
| Entity Type | Organization |
| Authorized Contact | JODY M BOGER Credentialing Coordinator 717-270-7780 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology |
| 208000000X Pediatrics | |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2016-10-04 |