Provider Demographics
NPI:1437158599
Name:D'AGATA, SAMUEL D (MD)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:D
Last Name:D'AGATA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 MEMORY LN
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2231
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:717-851-6969
Practice Address - Street 1:1227 BALTIMORE ST
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-4406
Practice Address - Country:US
Practice Address - Phone:717-812-7559
Practice Address - Fax:717-632-2422
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD043979E207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1519968OtherGATEWAY
PA30112674OtherAMERIHEALTH MERCY - WMG
PA001172799Medicaid
PA416732OtherHIGHMARK BLUE SHIELD
PA418249OtherUPMC
PA418249OtherUPMC
E23147Medicare UPIN
PA1519968OtherGATEWAY