Basic Information
| Provider Information | |||||||||
| NPI: | 1962481580 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NAYMICK | ||||||||
| FirstName: | STEPHEN | ||||||||
| MiddleName: | ANDREW | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20 NORTH ST | ||||||||
| Address2: | |||||||||
| City: | HANOVER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 173312275 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7176377755 | ||||||||
| FaxNumber: | 7176377142 | ||||||||
| Practice Location | |||||||||
| Address1: | 20 NORTH ST | ||||||||
| Address2: | |||||||||
| City: | HANOVER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 173312275 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7176377755 | ||||||||
| FaxNumber: | 7176377142 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/12/2006 | ||||||||
| LastUpdateDate: | 07/16/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/16/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | OS008103L | PA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 141054001 | 05 | PA | MEDICAID | NA745239 | 01 | PA | PA BLUE SHIELD | OTHER | 02090801 | 01 | PA | CAPITAL BC / KEYSTONE | OTHER | 1519539 | 01 | PA | GATEWAY | OTHER |