Provider Demographics
NPI:1700044591
Name:GOLDHAHN, LAWRENCE JAMES RONALD (MD)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:JAMES RONALD
Last Name:GOLDHAHN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:LARRY
Other - Middle Name:
Other - Last Name:GOLDHAHN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1803 MT. ROSE AVE
Mailing Address - Street 2:SUITE B3
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-3051
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:717-337-4249
Practice Address - Street 1:147 GETTYS ST
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-2534
Practice Address - Country:US
Practice Address - Phone:717-337-4216
Practice Address - Fax:717-337-4249
Is Sole Proprietor?:No
Enumeration Date:2008-05-28
Last Update Date:2021-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD440650207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1597281OtherGATEWAY
PA30097100OtherAMERIHEALTH MERCY-GH
PA102590858Medicaid
PA30097102OtherAMERIHEALTH MERCY-YH
PA2625618OtherHIGHMARK BLUE SHIELD
PA416893OtherUPMC HEALTH PLAN
PA102590858Medicaid
PA30097100OtherAMERIHEALTH MERCY-GH
PA218343EZ3Medicare PIN
PAP00954860Medicare PIN