Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | MD029068E | PA |
NPI | 1134112337 |
---|---|
Provider Name | Dr. David Charles Trostle |
First Address | Lebanon, PA 17042-7497 |
Second Address | Lebanon, PA 17042-7497 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2005 |
Last Update Date | 03/02/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0010280700002 | (05) | PA |
01512701 | CAPITAL BLUE CROSS (01) | |
1512972 | GATEWAY HEALTH PLAN (01) | |
81133 | HIGHMARK BLUE SHIELD (01) | |
B35202 | (02) |