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General NPI Number Information
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NPI Number | 1821054107
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Entity Type | Organization
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Legal Business Name | HUMMELSTOWN FAMILY MEDICINE PC
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Dates
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Enumeration Date | 04/25/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 215 W MAIN STREET
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City | HUMMELSTOWN
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State | PA
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Zip | 17036-1420
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Country | US
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Telephone | 717-566-8786
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Fax | 717-566-8702
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Provider Business Mailing Address
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Address Line | 215 W MAIN STREET
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City | HUMMELSTOWN
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State | PA
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Zip | 17036-1420
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Country | US
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Telephone | 717-566-8786
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Fax | 717-566-8702
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Authorized Official
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Title or Position | DO
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Name | DEANNE S ENDY
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Credential | DO
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Telephone | 717-566-8786
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0S006156L
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License Number State | PA
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