Basic Information
| Provider Information | |||||||||
| NPI: | 1982667754 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DIEHL | ||||||||
| FirstName: | MARK | ||||||||
| MiddleName: | P | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1803 MOUNT ROSE AVE | ||||||||
| Address2: | SUITE B3 | ||||||||
| City: | YORK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 174033051 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7178511405 | ||||||||
| FaxNumber: | 7173392771 | ||||||||
| Practice Location | |||||||||
| Address1: | 40 V-TWIN DR | ||||||||
| Address2: | SUITE 205 | ||||||||
| City: | GETTYSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 173257878 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7173392790 | ||||||||
| FaxNumber: | 7173392771 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/11/2006 | ||||||||
| LastUpdateDate: | 06/13/2016 | ||||||||
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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 | 207R00000X | OS012824 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RR0500X | OS012824 | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology |
ID Information
| ID | Type | State | Issuer | Description | 20077605 | 01 | PA | AMERIHEALTH MERCY-WMG | OTHER | 80602 | 01 | PA | GEISINGER HEALTH PLAN | OTHER | 101308844 | 05 | PA | MEDICAID | 1548009 | 01 | PA | GATEWAY-WMG | OTHER | 1744992 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | 932335 | 01 | MD | CAREFIRST MD BCBS | OTHER | 241340 | 01 | PA | UNISON-WMG | OTHER | 7335757 | 01 | PA | AETNA | OTHER | 50078161 | 01 | PA | CAPITAL BLUE CROSS-WMG | OTHER | 210561 | 01 | PA | JOHNS HOPKINS | OTHER |