Healthcare Provider Details

I. General information

NPI: 1518919570
Provider Name (Legal Business Name): PAUL DAVID BRETTSCHNEIDER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 09/22/2022
Certification Date: 09/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 N 21ST ST
CAMP HILL PA
17011-2204
US

IV. Provider business mailing address

503 N 21ST ST
CAMP HILL PA
17011-2204
US

V. Phone/Fax

Practice location:
  • Phone: 717-763-2376
  • Fax: 717-763-2261
Mailing address:
  • Phone: 717-763-2219
  • Fax: 717-972-4844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD062348L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License NumberMD062348L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: