Provider Demographics
NPI:1831154178
Name:HURSH, DALE (MD)
Entity type:Individual
Prefix:
First Name:DALE
Middle Name:
Last Name:HURSH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2110 HARRISBURG PIKE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2644
Mailing Address - Country:US
Mailing Address - Phone:717-544-3022
Mailing Address - Fax:717-544-3021
Practice Address - Street 1:2110 HARRISBURG PIKE
Practice Address - Street 2:SUITE 300
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2644
Practice Address - Country:US
Practice Address - Phone:717-544-3022
Practice Address - Fax:717-544-3021
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD044649L207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000718505OtherHIGHMARK
PA1417248OtherAETNA-HMO
PA2069914OtherMERCY
PA40246OtherGEISINGER
PA50055979OtherCAPITAL BLUE CROSS
PAP002392OtherGATEWAY
PA080174701OtherRR MEDICARE
PA5495042OtherAETNA-NON HMO
PA001279338 0014Medicaid
PA0555449000OtherINDEPENDENCE BLUE CROSS
PA2069914OtherUNISON
PA50055979OtherKEYSTONE HEALTH PLAN CENTRAL
PA50055979OtherCAPITAL BLUE CROSS
PA000718505OtherHIGHMARK