Individual
MICHAEL K IDUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
112 N 7TH ST, CHAMBERSBURG, PA 17201-1720
(717) 267-7164
(717) 267-7414
Mailing address
601 MEMORY LN, YORK, PA 17402-2231
(717) 851-1405
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
25MA08022800
NJ
207L00000X
Anesthesiology Physician
Primary
MD425631
PA
207LP2900X
Pain Medicine (Anesthesiology) Physician
MD425631
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001828361
HIGHMARK BLUE SHIELD
PA
01
—
050514
MEDICARE GROUP #
PA
05
—
10156623 0002
—
PA
01
—
120420418
DEPT OF LABOR
PA
01
—
1573434
GATEWAY
PA
01
—
1928717
AETNA HMO
PA
01
—
2183091
MAMSI
PA
01
—
240951
UNISON
PA
01
—
25-1716306
INFORMED
PA
01
—
50079823
CAPITAL BLUECROSS
PA
01
—
7788804
AETNA NON-HMO
PA
01
—
G920-0101/85XWCU
CAREFIRST
PA
01
—
MD425631
MEDICAL LICENSE
PA
01
—
P00627622
RAILROAD MEDICARE
PA
01
—
PEARL
HEALTH AMERICA
PA
Enumeration date
03/01/2006
Last updated
01/30/2025
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