Basic Information
| Provider Information | |||||||||
| NPI: | 1215939434 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HARVEY | ||||||||
| FirstName: | BENSON | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3421 CONCORD RD | ||||||||
| Address2: | |||||||||
| City: | YORK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 174029001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7178516110 | ||||||||
| FaxNumber: | 7178511999 | ||||||||
| Practice Location | |||||||||
| Address1: | 25 MONUMENT RD | ||||||||
| Address2: | SUITE 120 | ||||||||
| City: | YORK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 174035049 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7178516110 | ||||||||
| FaxNumber: | 7178511999 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2005 | ||||||||
| LastUpdateDate: | 07/14/2016 | ||||||||
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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 | 208600000X | MD034196E | PA | Y | Allopathic & Osteopathic Physicians | Surgery | 2086S0120X | MD034196E | PA | N | Allopathic & Osteopathic Physicians | Surgery | Pediatric Surgery | 2086S0129X | MD034196E | PA | N | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery | 208C00000X | MD034196E | PA | N | Allopathic & Osteopathic Physicians | Colon & Rectal Surgery |
ID Information
| ID | Type | State | Issuer | Description | 1521814 | 01 | PA | GATEWAY | OTHER | 30105308 | 01 | PA | AMERIHEALTH MERCY-WMG | OTHER | 094548 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | 043165600 | 05 | MD | MEDICAID | 183586 | 01 | PA | RR MEDICARE/PALMETTO GBA | OTHER | 001021435 | 05 | PA | MEDICAID | 02526500 | 01 | PA | CAIC | OTHER | 183586 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | 756030 | 01 | PA | UPMC | OTHER | 974212 | 01 | MD | CAREFIRST MD BCBS | OTHER |