Provider Demographics
NPI:1962403022
Name:VREELAND, JAMES HOGG (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:HOGG
Last Name:VREELAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:201 HOSPITAL DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:EVERETT
Mailing Address - State:PA
Mailing Address - Zip Code:15537-7019
Mailing Address - Country:US
Mailing Address - Phone:814-623-8761
Mailing Address - Fax:814-624-0419
Practice Address - Street 1:201 HOSPITAL DR
Practice Address - Street 2:SUITE 1
Practice Address - City:EVERETT
Practice Address - State:PA
Practice Address - Zip Code:15537-7019
Practice Address - Country:US
Practice Address - Phone:814-623-8761
Practice Address - Fax:814-624-0419
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-10
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD039327L208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001524130002Medicaid
PA199085Medicare PIN
PAB41163Medicare UPIN
PAP00251305Medicare PIN