Provider Demographics
NPI:1629003330
Name:SLOAN, RICHARD WALTER (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:WALTER
Last Name:SLOAN
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 1:515 GATEHOUSE LN E
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-4330
Mailing Address - Country:US
Mailing Address - Phone:717-751-0229
Mailing Address - Fax:717-880-0622
Practice Address - Street 1:515 GATEHOUSE LN E
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-4330
Practice Address - Country:US
Practice Address - Phone:717-751-0229
Practice Address - Fax:717-880-0622
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD020958E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1143603OtherAMERIHEALTH MERCY-YH
PA080170895OtherRAILROAD MEDICARE
MD615816OtherCAREFIRST MD BCBS
PAP002556OtherGATEWAY-YH
PA5537116OtherAETNA
PA81007OtherUNISON-YH
PA000663943Medicaid
PA251647OtherMAMSI-YH
PA37237OtherGEISINGER
PA01658302OtherCAPITAL BLUE CROSS-YH
PA155824OtherHIGHMARK BLUE SHIELD
PA16024OtherJOHNS HOPKINS
PA37237OtherGEISINGER
PAP002556OtherGATEWAY-YH