Provider Demographics
NPI:1053301663
Name:SAMPHILIPO, ANTHONY W (DO)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:W
Last Name:SAMPHILIPO
Suffix:
Gender:M
Credentials:DO
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Other - First Name:
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Mailing Address - Street 1:2110 HARRISBURG PIKE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17604-3200
Mailing Address - Country:US
Mailing Address - Phone:717-544-3191
Mailing Address - Fax:717-544-3637
Practice Address - Street 1:2110 HARRISBURG PIKE
Practice Address - Street 2:SUITE 100
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17604-3200
Practice Address - Country:US
Practice Address - Phone:717-544-3191
Practice Address - Fax:717-544-3637
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2007-09-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOS009470L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018108000002Medicaid
PA1114689OtherAETNA NON-HMO
PA1540079OtherGATEWAY HEALTH PLAN
PA58712 S1QAOtherGEISINGER HEALTH PLAN
PA695239OtherHIGHMARK BLUE SHIELD
PA50051558OtherCAPITAL BLUE CROSS
PA7133158OtherAETNA HMO
PAP00226910OtherRAILROAD MEDICARE
PAH21702OtherHEALTH ASSURANCE
PA58712 S1QAOtherGEISINGER HEALTH PLAN
PAH21702OtherHEALTH ASSURANCE