Healthcare Provider Details

I. General information

NPI: 1619964194
Provider Name (Legal Business Name): GREGORY ALAN FORTIER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2005
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 N 7TH ST
CHAMBERSBURG PA
17201-1722
US

IV. Provider business mailing address

601 MEMORY LN
YORK PA
17402-2231
US

V. Phone/Fax

Practice location:
  • Phone: 717-262-4660
  • Fax:
Mailing address:
  • Phone: 717-851-1405
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberMD038076E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: