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WELLSPAN MEDICAL GROUP NPI 1407431588


NPI Information

NPI: 1407431588
Provider Name: WELLSPAN MEDICAL GROUP
Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Organization

Specialization: Neurology

CLIA Number: 39D2118010

Address:
17 WESTERN MARYLAND PKWY STE 100
HAGERSTOWN, MD
ZIP 21740
Phone: (301) 797-9240
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WELLSPAN MEDICAL GROUP is a neurology psychiatry neurology in Hagerstown, MD. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. WELLSPAN MEDICAL GROUP NPI is 1407431588. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

17 WESTERN MARYLAND PKWY STE 100
HAGERSTOWN, MD
ZIP 21740-471
Phone: (301) 797-9240
Fax: (301) 797-9240

The provider's authorized official is Laura Frank .
The authorized official title is Credentialing Supervisor and has the following contact phone number (717) 851-6832.

The CLIA number assigned to this NPI record is 39D2118010 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 3/10/2021 and was last updated on 3/10/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12084N0400XPsychiatry & NeurologyNeurologyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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