1134124282 NPI number — SAMUEL F. HARSHBERGER M.D.

Table of content: ERIKA J OLTMANNS RD, LDN (NPI 1063914760)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134124282 NPI number — SAMUEL F. HARSHBERGER M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARSHBERGER
Provider First Name:
SAMUEL
Provider Middle Name:
F.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

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 Information

NPI Number:
1134124282
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
925 SETON DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CUMBERLAND
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21502-1817
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-724-7146
Provider Business Mailing Address Fax Number:
301-724-5628

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
925 SETON DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CUMBERLAND
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21502-1817
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-724-7146
Provider Business Practice Location Address Fax Number:
301-724-5628
Provider Enumeration Date:
06/16/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X , with the licence number:  D0017862 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0935010001 . This is a "ADMINASTAR DME" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 0935010001 . This is a "HEALTH NOW NY" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: T999001 . This is a "BC BS NATIONAL" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 0900399 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 433229 . This is a "MAMSI/MDIPA/OPT" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 5023127 . This is a "AETNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 68563301 . This is a "CAREFIRST BC BS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: H615F478 . This is a "UMWA MEDICARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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