1699776120 NPI number — ARNFINN B NANBJOR MD

Table of content: ARNFINN B NANBJOR MD (NPI 1699776120)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699776120 NPI number — ARNFINN B NANBJOR MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NANBJOR
Provider First Name:
ARNFINN
Provider Middle Name:
B
Provider Name Prefix Text:
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:
1699776120
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/02/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
601 NORLAND AVE
Provider Second Line Business Mailing Address:
SUITE 201
Provider Business Mailing Address City Name:
CHAMBERSBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17201-4235
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-263-9555
Provider Business Mailing Address Fax Number:
717-217-4218

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
501 E MAIN ST
Provider Second Line Business Practice Location Address:
POTOMAC CARDIOLOGY
Provider Business Practice Location Address City Name:
WAYNESBORO
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17268-2353
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-762-0552
Provider Business Practice Location Address Fax Number:
717-762-0808
Provider Enumeration Date:
08/09/2005

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: 174400000X , with the licence number:  MD423525 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: P00368361 . This is a "MEDICARE RAILROAD PIN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 100933326 0001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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