Provider Demographics
NPI:1982699583
Name:HIMMELREICH, LESTER L III (MD)
Entity Type:Individual
Prefix:
First Name:LESTER
Middle Name:L
Last Name:HIMMELREICH
Suffix:III
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 1:220 WILSON ST
Mailing Address - Street 2:STE 109
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17013-3650
Mailing Address - Country:US
Mailing Address - Phone:717-249-1929
Mailing Address - Fax:717-249-9332
Practice Address - Street 1:1995 TECHNOLOGY PKWY
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-8522
Practice Address - Country:US
Practice Address - Phone:717-782-3380
Practice Address - Fax:717-782-5716
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD029765E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001188959001Medicaid
PA001188959001Medicaid
PAHI577299Medicare ID - Type Unspecified