Provider Demographics
NPI:1336179001
Name:VANWYK, RITA ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:RITA
Middle Name:ELIZABETH
Last Name:VANWYK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:RITA
Other - Middle Name:VANWYK
Other - Last Name:DUE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:815 ARLINGTON RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-3101
Mailing Address - Country:US
Mailing Address - Phone:717-854-0713
Mailing Address - Fax:
Practice Address - Street 1:815 ARLINGTON RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-3101
Practice Address - Country:US
Practice Address - Phone:717-854-0713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD035277L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA30274OtherJOHN HOPKINS
PA001099545Medicaid
PA127491OtherHIGHMARK BLUE SHIELD
PA4313655OtherAETNA
PA549797OtherCAREFIRST MD BCBS
PA68175OtherGEISINGER
PA001099545Medicaid
PA127491OtherHIGHMARK BLUE SHIELD
PA127491Medicare PIN