Provider Demographics
NPI:1871598987
Name:MATHIAS, NORBERT PAUL (MD)
Entity type:Individual
Prefix:
First Name:NORBERT
Middle Name:PAUL
Last Name:MATHIAS
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 1:22 ST PAUL DR STE 200
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-1033
Mailing Address - Country:US
Mailing Address - Phone:717-709-7922
Mailing Address - Fax:717-263-2055
Practice Address - Street 1:830 5TH AVE STE 102
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-4224
Practice Address - Country:US
Practice Address - Phone:717-709-7979
Practice Address - Fax:717-709-7980
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD022511E207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
930051206OtherMEDICARE RAILROAD
PAD76016Medicare UPIN
143974GZ5Medicare PIN