Provider Demographics
NPI:1215931274
Name:MOHLER, J. HAROLD (MD)
Entity type:Individual
Prefix:
First Name:J.
Middle Name:HAROLD
Last Name:MOHLER
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:LANCASTER INTERNAL MEDICINE GROUP
Mailing Address - Street 2:817 NORTH CHERRY STREET
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602
Mailing Address - Country:US
Mailing Address - Phone:717-393-8131
Mailing Address - Fax:717-393-9107
Practice Address - Street 1:LANCASTER INTERNAL MEDICINE GROUP
Practice Address - Street 2:817 NORTH CHERRY STREET
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602
Practice Address - Country:US
Practice Address - Phone:717-393-8131
Practice Address - Fax:717-393-9107
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA021856E207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA73008804002OtherCIGNA PROVIDER NUMBER
PA01324501OtherCAPITAL BLUE CROSS PROV#
PA23656OtherGEISINGER HEALTHPLAN PROV
PA695177OtherAETNA US HEALTHCARE PROVI
PA0006942060002Medicaid
PA106758OtherBLUE SHIELD PROVIDER #
PA695177OtherAETNA US HEALTHCARE PROVI
PAB36698Medicare UPIN