Provider Demographics
NPI:1275517112
Name:ADER, MICHAEL HARRIS (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:HARRIS
Last Name:ADER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 FAME AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-1587
Mailing Address - Country:US
Mailing Address - Phone:717-632-9263
Mailing Address - Fax:717-646-7439
Practice Address - Street 1:250 FAME AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-1587
Practice Address - Country:US
Practice Address - Phone:717-632-9263
Practice Address - Fax:717-646-7439
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2021-01-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD028690E207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0009084650005Medicaid
PA0009084650005Medicaid
PA189393Medicare PIN