Provider Demographics
NPI:1295152932
Name:WILSKER, HERBERT BERNARD (MD)
Entity type:Individual
Prefix:MR
First Name:HERBERT
Middle Name:BERNARD
Last Name:WILSKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1001 MARIETTA AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603
Mailing Address - Country:US
Mailing Address - Phone:717-291-9893
Mailing Address - Fax:
Practice Address - Street 1:4641 WEST PORT DRIVE
Practice Address - Street 2:MILITARY ENTRANCE PROCESSING STATION
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-4843
Practice Address - Country:US
Practice Address - Phone:717-691-6183
Practice Address - Fax:717-691-8039
Is Sole Proprietor?:No
Enumeration Date:2014-03-19
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD032404L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAWI-129813Medicare UPIN