1265582613 NPI number — MATTHEW F GEORGY MD

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265582613 NPI number — MATTHEW F GEORGY MD

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

GEORGY

Provider First Name:

MATTHEW

Provider Middle Name:

F

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

MD

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1265582613

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

06/13/2016

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

1803 MT ROSE AVE

Provider Second Line Business Mailing Address:

SUITE B3

Provider Business Mailing Address City Name:

YORK

Provider Business Mailing Address State Name:

PA

Provider Business Mailing Address Postal Code:

17403-3051

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

717-851-1405

Provider Business Mailing Address Fax Number:

717-851-5114

Provider First Line Business Practice Location Address:

1001 S GEORGE ST

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

YORK

Provider Business Practice Location Address State Name:

PA

Provider Business Practice Location Address Postal Code:

17403-3676

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

717-851-5001

Provider Business Practice Location Address Fax Number:

717-851-5114

Provider Enumeration Date:

01/10/2007

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207ZP0102X , with the licence number:  MD432596 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
• Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

• Identifier: 102164300 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
• Identifier: 20076029 . This is a "AMERIHEALTH MERCY-WMG" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 210579 . This is a "JOHNS HOPKINS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 1572188 . This is a "GATEWAY-WMG" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 30156223 . This is a "AMERIHEATH CARITAS - GH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 9636169 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 2049969 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 118661 . This is a "GEISINGER HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 30124652 . This is a "AMERIHEALTH MERCY - WSRH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 244726 . This is a "UNISON-WMG" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 50078247 . This is a "CAPITAL BLUE CROSS-WMG" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".