Provider Demographics
NPI:1811935638
Name:KOLLER, HAROLD PAUL (MD)
Entity type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:PAUL
Last Name:KOLLER
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1650 HUNTINGDON PIKE
Mailing Address - Street 2:SUITE 150
Mailing Address - City:MEADOWBROOK
Mailing Address - State:PA
Mailing Address - Zip Code:19046-8004
Mailing Address - Country:US
Mailing Address - Phone:215-947-6660
Mailing Address - Fax:215-947-7425
Practice Address - Street 1:1650 HUNTINGDON PIKE
Practice Address - Street 2:SUITE 150
Practice Address - City:MEADOWBROOK
Practice Address - State:PA
Practice Address - Zip Code:19046-8004
Practice Address - Country:US
Practice Address - Phone:215-947-6660
Practice Address - Fax:215-947-7425
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2012-08-03
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Provider Licenses
StateLicense IDTaxonomies
LAMD009944E207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAB33157Medicare UPIN