Basic Information
| Provider Information | |||||||||
| NPI: | 1215931274 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MOHLER | ||||||||
| FirstName: | J. | ||||||||
| MiddleName: | HAROLD | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | LANCASTER INTERNAL MEDICINE GROUP | ||||||||
| Address2: | 817 NORTH CHERRY STREET | ||||||||
| City: | LANCASTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 17602 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7173938131 | ||||||||
| FaxNumber: | 7173939107 | ||||||||
| Practice Location | |||||||||
| Address1: | LANCASTER INTERNAL MEDICINE GROUP | ||||||||
| Address2: | 817 NORTH CHERRY STREET | ||||||||
| City: | LANCASTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 17602 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7173938131 | ||||||||
| FaxNumber: | 7173939107 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/08/2005 | ||||||||
| LastUpdateDate: | 06/16/2010 | ||||||||
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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 | 207R00000X | 021856E | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 207RN0300X | 021856E | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
ID Information
| ID | Type | State | Issuer | Description | 73008804002 | 01 | PA | CIGNA PROVIDER NUMBER | OTHER | 01324501 | 01 | PA | CAPITAL BLUE CROSS PROV# | OTHER | 23656 | 01 | PA | GEISINGER HEALTHPLAN PROV | OTHER | 695177 | 01 | PA | AETNA US HEALTHCARE PROVI | OTHER | 0006942060002 | 05 | PA | MEDICAID | 106758 | 01 | PA | BLUE SHIELD PROVIDER # | OTHER |