Provider Demographics
NPI:1841582921
Name:HARBERGER, ANNIE MELINDA (DO)
Entity Type:Individual
Prefix:
First Name:ANNIE
Middle Name:MELINDA
Last Name:HARBERGER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ANNIE
Other - Middle Name:MELINDA
Other - Last Name:GALBREATH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-812-4900
Mailing Address - Fax:717-259-7262
Practice Address - Street 1:105 4TH ST
Practice Address - Street 2:
Practice Address - City:EAST BERLIN
Practice Address - State:PA
Practice Address - Zip Code:17316-9638
Practice Address - Country:US
Practice Address - Phone:717-812-4900
Practice Address - Fax:717-255-0951
Is Sole Proprietor?:No
Enumeration Date:2011-05-09
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS016983207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102923310Medicaid
PA356361FLTMedicare PIN
PA102923310Medicaid