Provider Demographics
NPI:1013999044
Name:HUSAR, MICHAEL STEPHEN (DPM)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:STEPHEN
Last Name:HUSAR
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 MEMORY LN
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2231
Mailing Address - Country:US
Mailing Address - Phone:717-264-5211
Mailing Address - Fax:717-264-5418
Practice Address - Street 1:1920 SCOTLAND AVE
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-1450
Practice Address - Country:US
Practice Address - Phone:717-264-5211
Practice Address - Fax:717-264-5418
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC004801L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018795550001Medicaid
PA1315732OtherBLUE SHIELD
PA2678021OtherAETNA
U87010Medicare UPIN
PA0018795550001Medicaid