Individual
MATTHEW D BACHARACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
840 TUCK ST, LEBANON, PA 17042
(717) 675-2545
(717) 675-2550
Mailing address
840 TUCK ST, LEBANON, PA 17042-7477
(717) 675-2545
(717) 675-2550
Taxonomy
Speciality
Code
Description
License number
State
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
MD037966E
PA
208600000X
Surgery Physician
Primary
MD037966E
PA
2086S0129X
Vascular Surgery Physician
MD037966E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010942080005
—
PA
Enumeration date
01/26/2006
Last updated
06/06/2019
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