Provider Demographics
NPI:1831134139
Name:ISKANDAR, EMAD G (DO)
Entity Type:Individual
Prefix:DR
First Name:EMAD
Middle Name:G
Last Name:ISKANDAR
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 1:409 S 2ND ST
Mailing Address - Street 2:SUITE 2F
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17104-1612
Mailing Address - Country:US
Mailing Address - Phone:717-731-0101
Mailing Address - Fax:717-731-8359
Practice Address - Street 1:1000 N FRONT ST
Practice Address - Street 2:
Practice Address - City:WORMLEYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17043-1034
Practice Address - Country:US
Practice Address - Phone:717-731-0101
Practice Address - Fax:717-441-0706
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2021-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS013536207R00000X, 207RC0000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101747380Medicaid
PA2161248OtherMAMSI-WMG
PA206053OtherJOHNS HOPKINS
PA1553867OtherGATEWAY-WMG
MD890210OtherCAREFIRST MD BCBS
PA2756687000OtherAMERIHEALTH 65 PA
PA50062660OtherCAPITAL BLUE CROSS-WMG
PA1892043OtherHIGHMARK BLUE SHIELD
PA20056986OtherAMERIHEALTH MERCY-WMG
PA7704883OtherAETNA
PA103041OtherGEISINGER
PA188660OtherUNISON-WMG
PA20056986OtherAMERIHEALTH MERCY-WMG
I66526Medicare UPIN