Basic Information
| Provider Information | |||||||||
| NPI: | 1053517904 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MINHAS | ||||||||
| FirstName: | OMAR | ||||||||
| MiddleName: | SAJJAD | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1803 MOUNT ROSE AVE | ||||||||
| Address2: | SUITE B3 | ||||||||
| City: | YORK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 174033026 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7178511405 | ||||||||
| FaxNumber: | 7178512010 | ||||||||
| Practice Location | |||||||||
| Address1: | 1575 BANNISTER ST | ||||||||
| Address2: | SUITE 1 | ||||||||
| City: | YORK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 174044946 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7178122000 | ||||||||
| FaxNumber: | 7178512010 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2007 | ||||||||
| LastUpdateDate: | 10/22/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD432016 | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 211724 | 01 | PA | JOHNS HOPKINS | OTHER | 2857463000 | 01 | PA | AMERIHEALTH 65 PA | OTHER | 906892 | 01 | MD | CAREFIRST MD MCBS | OTHER | 223432 | 01 | PA | UNISON-WMG | OTHER | P008484 | 01 | PA | GATEWAY-WMG | OTHER | 101974664 | 05 | PA | MEDICAID | 20066823 | 01 | PA | AMERIHEALTH MERCY-WMG | OTHER | 50071590 | 01 | PA | CAPITAL BLUE CROSS-WMG | OTHER | 50083198 | 01 | PA | CAPITAL BLUE CROSS-WMG CFA | OTHER | 110594 | 01 | PA | GEISINGER | OTHER | 1979747 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | 2169800 | 01 | PA | MAMSI-WMG | OTHER | 259835 | 01 | PA | UNISON-WMG CFA | OTHER | 9680079 | 01 | PA | AETNA | OTHER |