Basic Information
| Provider Information | |||||||||
| NPI: | 1538540950 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | UNAL | ||||||||
| FirstName: | IMRAN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2201 BRUNSWICK DR STE 2300 | ||||||||
| Address2: | |||||||||
| City: | HANOVER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 173318350 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7173163670 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2201 BRUNSWICK DR STE 2300 | ||||||||
| Address2: | |||||||||
| City: | HANOVER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 173318350 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7173163670 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2015 | ||||||||
| LastUpdateDate: | 07/28/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/28/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD472912 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | MT208860 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 390200000X | MT208860 | PA | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207RE0101X | MD472912 | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism |
ID Information
| ID | Type | State | Issuer | Description | 103296680 | 05 | PA | MEDICAID |