Provider Demographics
NPI:1568462273
Name:MARTZLUF, DOUGLAS R (MD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:R
Last Name:MARTZLUF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:785 5TH AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4232
Mailing Address - Country:US
Mailing Address - Phone:717-263-9555
Mailing Address - Fax:717-217-4217
Practice Address - Street 1:757 NORLAND AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-4230
Practice Address - Country:US
Practice Address - Phone:717-217-6760
Practice Address - Fax:717-217-6702
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD023608E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000633603 0005Medicaid
PA120420409OtherDEPT OF LABOR
PA122664OtherUNISON
PA1336336OtherFIRST HEALTH
PA247736OtherMAMSI
PA25-1716306OtherINFORMED
PA426727OtherHEALTH AMERICA
PA841779OtherAETNA HMO
PA867633OtherMEDICARE GROUP #
PA080087935OtherRAILROAD MEDICARE
PA25-1716306OtherMULTIPLAN/PHCS
PA25-1716306OtherINTERGROUP
PA25-1716306OtherGREATWEST
PA1651301OtherCAPITAL BLUECROSS
PA25-1716306OtherHEALTHNET/TRICARE
PA25-1716306OtherSOUTH CENTRAL PREFERRED
PA152796OtherHIGHMARK BLUESHIELD
PA25-1716306OtherDEVON
PA4307239OtherAETNA NON-HMO
PAMD023608EOtherLICENSE
PAP006018OtherGATEWAY
PA1007307260034OtherMEDICAID GROUP #
PA1007307260034OtherMEDICAID GROUP #
PA25-1716306OtherINTERGROUP
PA25-1716306OtherINFORMED