Provider Demographics
NPI:1063487767
Name:THE MILTON S HERSHEY MEDICAL CENTER PHYSICIAN GROUP
Entity Type:Organization
Organization Name:THE MILTON S HERSHEY MEDICAL CENTER PHYSICIAN GROUP
Other - Org Name:MSHMC - INTERNAL MEDICINE
Other - Org Type:Other Name
Authorized Official - Title/Position:INTERIM CFO
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:G
Authorized Official - Last Name:SWINKO
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:717-531-8405
Mailing Address - Street 1:PO BOX 854
Mailing Address - Street 2:MCA410
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-0854
Mailing Address - Country:US
Mailing Address - Phone:717-531-5995
Mailing Address - Fax:717-531-6934
Practice Address - Street 1:670 CHERRY DR
Practice Address - Street 2:
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-2003
Practice Address - Country:US
Practice Address - Phone:800-243-1455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-17
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007452910087Medicare ID - Type Unspecified
PA036515Medicare ID - Type Unspecified