Provider Demographics
NPI:1497795058
Name:BULGER, DONALD W (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:W
Last Name:BULGER
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 1:365 WARD DRIVE
Mailing Address - Street 2:PO BOX 267
Mailing Address - City:CLAYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16625-9742
Mailing Address - Country:US
Mailing Address - Phone:814-239-2211
Mailing Address - Fax:814-239-8116
Practice Address - Street 1:365 WARD DRIVE
Practice Address - Street 2:
Practice Address - City:CLAYSBURG
Practice Address - State:PA
Practice Address - Zip Code:16625-9742
Practice Address - Country:US
Practice Address - Phone:814-239-2211
Practice Address - Fax:814-239-8116
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD025284E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1037005Medicaid
PA1037005Medicaid
PA1933990E0WMedicare PIN