Provider Demographics
NPI:1114924719
Name:SMELTZ, HARRY BART (DO)
Entity Type:Individual
Prefix:DR
First Name:HARRY
Middle Name:BART
Last Name:SMELTZ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 SPRUCE ST
Mailing Address - Street 2:6 DULLES
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4206
Mailing Address - Country:US
Mailing Address - Phone:215-349-8310
Mailing Address - Fax:215-545-1543
Practice Address - Street 1:3400 SPRUCE ST
Practice Address - Street 2:6 DULLES
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4206
Practice Address - Country:US
Practice Address - Phone:215-349-8310
Practice Address - Fax:215-545-1543
Is Sole Proprietor?:No
Enumeration Date:2005-06-29
Last Update Date:2012-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS007691L207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASM25197OtherPA BLUE SHIELD
NJ5108101Medicaid
PA0012795250005Medicaid
PAF24641Medicare UPIN
PA025197Medicare ID - Type Unspecified