Organization
PENNSYLVANIA TOXICOLOGISTS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH WARD DONOVAN MD (PRESIDENT)
(717) 782-5185
Entity
Organization
Contact information
Practice address
111 S FRONT ST, HARRISBURG, PA 17101
(717) 782-5185
(717) 782-5188
Mailing address
PO BOX 517, HAZLETON, PA 18201-0517
(570) 450-6200
(570) 450-6207
Taxonomy
Speciality
Code
Description
License number
State
2083T0002X
Medical Toxicology (Preventive Medicine) Physician
Primary
MD036157L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006642430005
—
PA
05
—
1016451290001
—
PA
05
—
1019058810001
—
PA
Enumeration date
05/31/2006
Last updated
07/23/2008
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