1366639023 NPI number — DR. ANISH HARDEEP TREHUN MD

Table of content: DR. ANISH HARDEEP TREHUN MD (NPI 1366639023)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366639023 NPI number — DR. ANISH HARDEEP TREHUN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TREHUN
Provider First Name:
ANISH
Provider Middle Name:
HARDEEP
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1366639023
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/03/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 HOSPITAL WAY
Provider Second Line Business Mailing Address:
BUTLER HOSPITAL CARE ASSOCIATES
Provider Business Mailing Address City Name:
BUTLER
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16001-4670
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-284-5670
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
130 GREENBRIER DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RIPLEY
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25271-1645
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-335-5040
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/26/2007

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: 208000000X , with the licence number:  MD456406 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 208000000X , with the licence number: 24341 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 3810020223 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".




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