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NPI Code Detail

MEDICARE: DR. CARLOS J VIDAL MD

MEDICARE: DR. CARLOS J VIDAL MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianBV7875214PA
2207R00000XInternal Medicine PhysicianMD420108PA
3208M00000XHospitalist PhysicianD81367MD
4208M00000XHospitalist PhysicianMD420108PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1225023765
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CARLOS J VIDAL MD
Provider Business Mailing Address
First Line : 601 MEMORY LN
Second Line :
City : YORK
State : PA
Zip : 17402-2231
Country : US
Telephone Number : 717-851-1405
Fax Number : 717-851-6969
Provider Business Practice Location Address
First Line : 147 GETTYS ST
Second Line :
City : GETTYSBURG
State : PA
Zip : 17325-2534
Country : US
Telephone Number : 717-339-2025
Fax Number : 717-339-2011
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/12/2005
Last Update Date : 09/16/2024

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Directions to “ DR. CARLOS J VIDAL MD” Practice Location

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