Provider Demographics
NPI:1093753105
Name:HERSHNER, PAMELA MARTIN (DO)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:MARTIN
Last Name:HERSHNER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:ANN
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:555 N DUKE ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-2250
Mailing Address - Country:US
Mailing Address - Phone:717-544-5511
Mailing Address - Fax:
Practice Address - Street 1:694 GOOD DR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601
Practice Address - Country:US
Practice Address - Phone:717-544-3737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2018-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS012338207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA20021034OtherMERCY
PA50056062OtherCAPITAL BLUE CROSS/KEYSTONE HEALTH PLAN CENTRAL
PA001921425 0004Medicaid
PA2112861000OtherINDEPENDENCE BLUE CROSS
PA1417182OtherAETNA-HMO
PA000000137362OtherUNISON
PA160058544OtherRR MEDICARE
PA30026426OtherKEYSTONE MERCY
PA7838686OtherAETNA-NON HMO
PA001427644OtherHIGHMARK
PA1525208OtherGATEWAY
PA7838686OtherAETNA-NON HMO
PA001921425 0004Medicaid