Individual
DR. MICHAEL DANIEL HAROSTOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.9
Contact information
Practice address
1000 E MOUNTAIN BLVD, WILKES BARRE, PA 18711-0027
(570) 808-6020
(570) 808-2306
Mailing address
100 NORTH ACADEMY AVE., DANVILLE, PA 17822-4903
(570) 271-6144
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
MD028903E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009611590006
—
PA
05
—
0018673110002
—
PA
01
—
378976
HEALTH AMERICA
PW
01
—
432226
MEDICARE #
PA
01
—
798833
UNITED HEALTHCARE
PA
Enumeration date
07/13/2005
Last updated
08/20/2020
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