Provider Demographics
NPI:1669440517
Name:HERSHBERGER, DAVID G (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:G
Last Name:HERSHBERGER
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 1:551 MAIN ST
Mailing Address - Street 2:THE INFORMEDX GROUP 3RD FLOOR
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15901
Mailing Address - Country:US
Mailing Address - Phone:814-539-5724
Mailing Address - Fax:814-536-7092
Practice Address - Street 1:290 HAIDA AVE
Practice Address - Street 2:MINERS HOSPITAL EMERGENCY PHYSICIANS GROUP
Practice Address - City:HASTINGS
Practice Address - State:PA
Practice Address - Zip Code:16646
Practice Address - Country:US
Practice Address - Phone:814-247-3100
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD027166E207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
B41113Medicare UPIN
PA197435Medicare ID - Type Unspecified