| Baxter Drew Wellmon Ii D.o.,p.c. | |
|
97 Progress Blvd Suite 1 Shippensburg PA 17257-8131 | |
| (717) 532-3211 | |
| (717) 532-3099 |
| Full Name | Baxter Drew Wellmon Ii D.o.,p.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 97 Progress Blvd, Shippensburg, Pennsylvania |
| Authorized Official Name and Position | Baxter Drew Wellmon (OWNER) |
| Authorized Official Contact | 7175323211 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Baxter Drew Wellmon Ii D.o.,p.c. 97 Progress Blvd Suite 1 Shippensburg PA 17257-8131 Ph: (717) 532-3211 | Baxter Drew Wellmon Ii D.o.,p.c. 97 Progress Blvd Suite 1 Shippensburg PA 17257-8131 Ph: (717) 532-3211 |
| NPI Number | 1356474456 |
|---|---|
| Provider Enumeration Date | 03/14/2007 |
| Last Update Date | 12/10/2008 |
| Medicare PECOS PAC ID | 5698836583 |
|---|---|
| Medicare Enrollment ID | O20081210000718 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356474456 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | OS009662L (Pennsylvania) | Primary |
| Provider Name | Baxter D Wellmon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518007020 PECOS PAC ID: 4183785231 Enrollment ID: I20081208000142 |
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