Basic Information
| Provider Information | |||||||||
| NPI: | 1487616322 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DHAR | ||||||||
| FirstName: | SANJAY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | M.D | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | |||||||||
| OtherFirstName: | |||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | |||||||||
| Mailing Information | |||||||||
| Address1: | 785 5TH AVENUE | ||||||||
| Address2: | SUITE 3 | ||||||||
| City: | CHAMBERSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 172014232 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172639555 | ||||||||
| FaxNumber: | 7172174217 | ||||||||
| Practice Location | |||||||||
| Address1: | 112 N 7TH ST | ||||||||
| Address2: | |||||||||
| City: | CHAMBERSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 172011720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172174300 | ||||||||
| FaxNumber: | 7172174217 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/05/2006 | ||||||||
| LastUpdateDate: | 02/05/2020 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | |||||||||
| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | M | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | Y | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 02/05/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD420611 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | MD420611 | PA | Y | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | 001923420 0003 | 05 | PA | MEDICAID | 25-1716306 | 01 | PA | SOUTH CENTRAL PREFERRED | OTHER | 50055993 | 01 | PA | CAPITAL BLUE CROSS-WMG | OTHER | 867633 | 01 | PA | MEDICARE GROUP # | OTHER | P00468815 | 01 | PA | RAILROAD MEDICARE | OTHER | 1530252 | 01 | PA | GATEWAY-WMG | OTHER | 243488 | 01 | PA | UNISON-WMG | OTHER | 25-1716306 | 01 | PA | INTERGROUP | OTHER | 7184446 | 01 | PA | AETNA NON-HMO | OTHER | 0019234200004 | 05 | PA | MEDICAID | 1149404 | 01 | PA | FIRST HEALTH | OTHER | 120420410 | 01 | PA | DEPT OF LABOR | OTHER | 1436398 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | 25-1716306 | 01 | PA | INFORMED | OTHER | 25-1716306 | 01 | PA | GREATWEST | OTHER | 25-1716306 | 01 | PA | HEALTHNET/TRICARE | OTHER | 1839596 | 01 | PA | AETNA HMO | OTHER | 20090429 | 01 | PA | AMERIHEALTH MERCY-WMG | OTHER | 25-1716306 | 01 | PA | DEVON | OTHER | 25-1716306 | 01 | PA | MULTIPLAN/PHCS | OTHER | 928593-02 | 01 | MD | CAREFIRST MD BCBS | OTHER | BD8045886 | 01 | PA | DEA | OTHER | 1530252 | 01 | PA | GATEWAY | OTHER | 018514100 | 05 | MD | MEDICAID | 211698 | 01 | PA | JOHNS HOPKINS | OTHER | 234629 | 01 | PA | UNISON (HFC) | OTHER | 783867 | 01 | PA | HEALTH AMERICA | OTHER | 2183752 | 01 | PA | MAMSI | OTHER | 3395 | 01 | PA | GEISINGER HEALTH PLAN | OTHER | 50075853 | 01 | PA | CAPITAL BLUECROSS | OTHER | G920-0082/KDM4CU | 01 | PA | CAREFIRST | OTHER | MD420611 | 01 | PA | MEDICAL LICENSE | OTHER |