Provider Demographics
NPI:1417972746
Name:PRILL, DONNA MAUREEN (MD)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:MAUREEN
Last Name:PRILL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 MEMORY LN
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2231
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:
Practice Address - Street 1:3106 PHILADELPHIA AVE
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-8938
Practice Address - Country:US
Practice Address - Phone:717-264-3644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA071272207Q00000X
NYNY203755207Q00000X
MO2017030494207Q00000X
PABP4558536207Q00000X
PAMD483242207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGA1594Medicaid
GA003142498AMedicaid
NY01694531Medicaid
GAP01279489OtherRAILROAD MEDICARE
G19651Medicare UPIN
SCGA1594Medicaid
NY686421Medicare PIN