Healthcare Provider Details

I. General information

NPI: 1891739330
Provider Name (Legal Business Name): MICHAEL J ESHLEMAN PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 06/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 S GEORGE ST
YORK PA
17403-4508
US

IV. Provider business mailing address

3421 CONCORD RD
YORK PA
17402-9001
US

V. Phone/Fax

Practice location:
  • Phone: 717-812-4200
  • Fax: 717-845-4791
Mailing address:
  • Phone: 717-812-4200
  • Fax: 717-845-4791

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS004575L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS004575L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: