Provider Demographics
NPI:1437150372
Name:LINE, DENNIS E (MD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:E
Last Name:LINE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:409 S 2ND ST STE 2F
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17104-1612
Mailing Address - Country:US
Mailing Address - Phone:717-231-8937
Mailing Address - Fax:717-231-8588
Practice Address - Street 1:1000 N FRONT ST
Practice Address - Street 2:SUITE 200
Practice Address - City:WORMLEYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17043-1034
Practice Address - Country:US
Practice Address - Phone:717-731-0101
Practice Address - Fax:717-441-0592
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2017-11-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD0016090E207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006563680001Medicaid
PA34319FWHMedicare ID - Type Unspecified
PAC28249Medicare UPIN