Healthcare Provider Details

I. General information

NPI: 1669408035
Provider Name (Legal Business Name): ARLENE SKURKIS BOBONICH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 08/25/2020
Certification Date: 08/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 NORTH 21ST ST.
CAMP HILL PA
17110-8531
US

IV. Provider business mailing address

100 NORTH ACADEMY AVE.
DANVILLE PA
17822-4903
US

V. Phone/Fax

Practice location:
  • Phone: 717-763-2100
  • Fax:
Mailing address:
  • Phone: 570-271-6144
  • Fax: 570-271-6578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD056474L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number18307
License Number StateNV
# 3
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License NumberMD056474L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: