Provider Demographics
NPI:1700824299
Name:UNGER, DONALD (DO)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:
Last Name:UNGER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3535 PINE AVE
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16504-1743
Mailing Address - Country:US
Mailing Address - Phone:814-456-5469
Mailing Address - Fax:814-453-2698
Practice Address - Street 1:4950 BUFFALO RD
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16510-2304
Practice Address - Country:US
Practice Address - Phone:814-898-2576
Practice Address - Fax:814-898-8790
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS007756L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001463526Medicaid
PA766459Medicare ID - Type UnspecifiedINDVIDUAL NUMBER