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NPI Code Detail

MEDICARE: J EDWARD DAGEN MD PC

MEDICARE: J EDWARD DAGEN MD PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208800000XUrology PhysicianMD017601EPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
19390390OTHERPACIGNA
2095786OTHERPABLUE SHIELD
303250401OTHERPACAPITAL BLUE CROSS
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5527353OTHERPAAETNA

General Provider Information

NPI Number : 1174746952
Entity Type Code : Organization
Provider Name (Legal Business Name) : J EDWARD DAGEN MD PC
Provider Business Mailing Address
First Line : 9 BROOKWOOD AVE
Second Line :
City : CARLISLE
State : PA
Zip : 17013-9126
Country : US
Telephone Number : 717-245-0131
Fax Number : 717-245-9611
Provider Business Practice Location Address
First Line : 9 BROOKWOOD AVE
Second Line :
City : CARLISLE
State : PA
Zip : 17013-9126
Country : US
Telephone Number : 717-245-0131
Fax Number : 717-245-9611
Authorized Official
Title or Position : PRESIDENT
Name : DR. J EDWARD DAGEN
Credential : M.D.
Telephone Number : 717-245-0131
Provider Enumeration Date : 04/10/2007
Last Update Date : 08/22/2020

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