Provider Demographics
NPI:1366426835
Name:ENGLE, EUGENE K (MD)
Entity type:Individual
Prefix:
First Name:EUGENE
Middle Name:K
Last Name:ENGLE
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 1:80 DOE RUN RD
Mailing Address - Street 2:
Mailing Address - City:MANHEIM
Mailing Address - State:PA
Mailing Address - Zip Code:17545-9314
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:80 DOE RUN RD
Practice Address - Street 2:
Practice Address - City:MANHEIM
Practice Address - State:PA
Practice Address - Zip Code:17545-9314
Practice Address - Country:US
Practice Address - Phone:717-664-0952
Practice Address - Fax:717-664-0955
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2020-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD019421E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01423702OtherCAPITAL BLUE CROSS
PA032527OtherHIGHMARK BLUE SHIELD
PAC28135OtherHEALTH ASSURANCE
PA0006717300001Medicaid
PAP002641OtherGATEWAY HEALTH PLAN
PAC28135OtherHEALTH ASSURANCE
PAC28135Medicare UPIN