Provider Demographics
NPI:1174563076
Name:HARTUNG, STEVEN ALAN (DPM)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:ALAN
Last Name:HARTUNG
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1431 WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701-5424
Mailing Address - Country:US
Mailing Address - Phone:570-323-7848
Mailing Address - Fax:570-323-4681
Practice Address - Street 1:1431 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-5424
Practice Address - Country:US
Practice Address - Phone:570-323-7848
Practice Address - Fax:570-323-4681
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC003444L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA3956670001OtherMEDICARE DME
PA0014198500001Medicaid
PA000653468OtherHIGHMARK BLUE SHIELD
PA073559OtherFIRST PRIORITY HEALTH
PA480011503OtherRAILROAD MEDICARE
PA3956670001OtherMEDICARE DME
PA073559OtherFIRST PRIORITY HEALTH