Provider Demographics
NPI:1154583599
Name:LUMSDEN, NICHOLAS ADAM (MD)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:ADAM
Last Name:LUMSDEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-812-2501
Mailing Address - Fax:717-812-2510
Practice Address - Street 1:13515 WOLFE RD
Practice Address - Street 2:STE C
Practice Address - City:NEW FREEDOM
Practice Address - State:PA
Practice Address - Zip Code:17349-9346
Practice Address - Country:US
Practice Address - Phone:717-812-2501
Practice Address - Fax:717-461-7178
Is Sole Proprietor?:No
Enumeration Date:2008-06-26
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD443443207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA760787OtherUPMC
PAP010283OtherGATEWAY
PA102623725Medicaid
PA2650356OtherHIGHMARK BLUE SHIELD
PA30103545OtherAMERIHEALTH MERCY-WMG
PA30103545OtherAMERIHEALTH MERCY-WMG
PA102623725Medicaid