Provider Demographics
NPI:1689645277
Name:LICHTER, JAMES G (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:G
Last Name:LICHTER
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 1:1604 BURTNER RD
Mailing Address - Street 2:
Mailing Address - City:NATRONA HEIGHTS
Mailing Address - State:PA
Mailing Address - Zip Code:15065-2845
Mailing Address - Country:US
Mailing Address - Phone:724-230-3030
Mailing Address - Fax:724-230-3001
Practice Address - Street 1:1604 BURTNER RD
Practice Address - Street 2:
Practice Address - City:NATRONA HEIGHTS
Practice Address - State:PA
Practice Address - Zip Code:15065-2845
Practice Address - Country:US
Practice Address - Phone:724-230-3030
Practice Address - Fax:724-230-3001
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD016026E207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA106546Medicare ID - Type Unspecified
PAB36688Medicare UPIN