Provider Demographics
NPI:1497773162
Name:BRANGO, CARL WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:WILLIAM
Last Name:BRANGO
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 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-812-5020
Mailing Address - Fax:717-461-7144
Practice Address - Street 1:10 MUDDY CREEK FORKS RD
Practice Address - Street 2:SUITE 3
Practice Address - City:BROGUE
Practice Address - State:PA
Practice Address - Zip Code:17309-9497
Practice Address - Country:US
Practice Address - Phone:717-812-5020
Practice Address - Fax:717-461-7144
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD054551L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA276738OtherUNISON-WMG
MD543718OtherCAREFIRST MD BCBS
PA1142415OtherAH MERCY-WMG SVF
PA01112102OtherCAPITAL BLUE CROSS-WMG
PA34917OtherGEISINGER
PA20092060OtherAMERIHEALTH MERCY
PA5260001OtherAETNA
PA001523820Medicaid
PAP002830OtherGATEWAY-WMG
PA152606OtherUNISON-WMG CFA
PA30054OtherJOHNS HOPKINS
PA686609OtherHIGHMARK BLUE SHIELD
PA233296OtherMAMSI-WMG
PA82566OtherUNISON-WMG SVFM
PA233296OtherMAMSI-WMG
PA080070807Medicare PIN
PA152606OtherUNISON-WMG CFA