MEDICARE: PHILIP A NEIDERER DO

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
1	207R00000X	Internal Medicine Physician	05007162L	PA

Other Identifiers

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

General Provider Information

NPI Number	:	1922093509
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHILIP A NEIDERER DO

Provider Business Mailing Address
First Line	:	3421 CONCORD RD
Second Line	:
City	:	YORK
State	:	PA
Zip	:	17402-9001
Country	:	US
Telephone Number	:	717-249-1929
Fax Number	:	717-249-9332

Provider Business Practice Location Address
First Line	:	220 WILSON ST
Second Line	:	STE 109
City	:	CARLISLE
State	:	PA
Zip	:	17013-3697
Country	:	US
Telephone Number	:	717-249-1929
Fax Number	:	717-249-9332

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2005
Last Update Date	:	01/17/2023

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1912993007 — WILLIAM R VONAH MD
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220 WILSON ST , SUITE 109
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1073509832 — MS. MICHELLE L. LATSHA PA-C
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1699761304 — DEBRA D TAYLOR MD
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Directions to “ PHILIP A NEIDERER DO” Practice Location

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