Provider Demographics
NPI:1700889847
Name:PINK, STUART B (MD)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:B
Last Name:PINK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2808 OLD POST RD
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17110-3685
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2808 OLD POST RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17110-3685
Practice Address - Country:US
Practice Address - Phone:717-920-4400
Practice Address - Fax:717-920-4553
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD041227E207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001127096Medicaid
PA089548Medicare PIN
PA001127096Medicaid
060012836OtherRAILROAD MEDICARE