Provider Demographics
NPI:1851376685
Name:SAILER, DALE W (MD)
Entity Type:Individual
Prefix:
First Name:DALE
Middle Name:W
Last Name:SAILER
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 1:562 W 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:LITITZ
Mailing Address - State:PA
Mailing Address - Zip Code:17543-1816
Mailing Address - Country:US
Mailing Address - Phone:717-626-2167
Mailing Address - Fax:717-626-1915
Practice Address - Street 1:562 W 2ND AVE
Practice Address - Street 2:
Practice Address - City:LITITZ
Practice Address - State:PA
Practice Address - Zip Code:17543-1816
Practice Address - Country:US
Practice Address - Phone:717-626-2167
Practice Address - Fax:717-626-1915
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2007-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD031698E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01851402OtherCAPITAL BLUE CROSS
PA17040 S1QGOtherGEISINGER HEALTH PLAN
PAP002687OtherGATEWAY HEALTH PLAN
PA4513167OtherAETNA NON-HMO
PA0010539490002Medicaid
PA472327OtherHIGHMARK BLUE SHIELD
PAB42131OtherHEALTH ASSURANCE
PA460640OtherAETNA HMO
PA472327JZEMedicare PIN
PA17040 S1QGOtherGEISINGER HEALTH PLAN