Healthcare Provider Details

I. General information

NPI: 1700824299
Provider Name (Legal Business Name): DONALD UNGER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 09/08/2022
Certification Date: 09/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4950 BUFFALO RD
ERIE PA
16510-2304
US

IV. Provider business mailing address

3535 PINE AVE 1ST FLOOR
ERIE PA
16504-1743
US

V. Phone/Fax

Practice location:
  • Phone: 814-898-2576
  • Fax: 814-898-8790
Mailing address:
  • Phone: 814-456-5469
  • Fax: 814-453-2698

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS007756L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: