Provider Demographics
NPI:1356360085
Name:ZELECHOSKI, DAVID MARK (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:MARK
Last Name:ZELECHOSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1 HOSPITAL DR
Mailing Address - Street 2:SUITE 306
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837-9350
Mailing Address - Country:US
Mailing Address - Phone:570-522-4110
Mailing Address - Fax:570-768-3911
Practice Address - Street 1:7055 WESTBRANCH HWY
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-6808
Practice Address - Country:US
Practice Address - Phone:570-524-4141
Practice Address - Fax:570-524-5218
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD039218E207RC0000X, 207RE0101X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA10754OtherBLUE SHIELD
PA254363HOtherGEISINGER
PA50000874OtherCAPITAL BLUE CROSS
PA50000874OtherKEYSTONE
PAE12823OtherHEALTH AMERICA
PA118438710OtherDEPARTMENT OF LABOR
PA232809429OtherTRICARE
PAP00139424OtherRAILROAD MEDICARE
PA0011546380004Medicaid
PA20011512OtherAMERIHEALTH
PA0011546380004Medicaid
PAE12823OtherHEALTH AMERICA