Provider Demographics
NPI:1477542280
Name:HARTMAN, DOROTHY (MD)
Entity type:Individual
Prefix:
First Name:DOROTHY
Middle Name:
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 MACK BLVD FL 4
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-5622
Mailing Address - Country:US
Mailing Address - Phone:484-884-4500
Mailing Address - Fax:
Practice Address - Street 1:1200 S CEDAR CREST BLVD FL 2
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6202
Practice Address - Country:US
Practice Address - Phone:610-402-6164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD039106E207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01169004OtherGATEWAY
PA0430153OtherKHP CENTRAL
PA430153OtherHIGHMARK
PA0207246000OtherINDEP. BLUE CROSS
PA0011690040001Medicaid
PA1004238OtherAMERIHEALTH MERCY
PA000000116864OtherTHREE RIVERS
PA30000869OtherKEYSTONE MERCY
PA1004238OtherAMERIHEALTH MERCY
PA050023961Medicare PIN
PA0207246000OtherINDEP. BLUE CROSS