Provider Demographics
NPI:1669440186
Name:NARAHARI, PREMNATH (MD)
Entity type:Individual
Prefix:DR
First Name:PREMNATH
Middle Name:
Last Name:NARAHARI
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 1:601 MEMORY LN
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2231
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:
Practice Address - Street 1:954 ISABEL DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-7482
Practice Address - Country:US
Practice Address - Phone:717-376-1180
Practice Address - Fax:717-273-6937
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD041165E207RG0100X
FLME126403207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA532504OtherBLUE SHIELD
FL017525100Medicaid
FL34FI5OtherBCBS
PA0011522680002Medicaid
PA532504OtherBLUE SHIELD
PA0011522680002Medicaid
FL017525100Medicaid