Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | MD028903E | PA |
NPI | 1013915008 |
---|---|
Provider Name | Dr. Michael Daniel Harostock |
First Address | Danville, PA 17822-4903 |
Second Address | Wilkes Barre, PA 18711-0027 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2005 |
Last Update Date | 20/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0009611590006 | (05) | PA |
0018673110002 | (05) | PA |
378976 | HEALTH AMERICA (01) | PW |
432226 | MEDICARE # (01) | PA |
798833 | UNITED HEALTHCARE (01) | PA |
D29694 | (02) |