Individual
GARY F UPDEGROVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
30 HOPE DR STE 2400, HERSHEY, PA 17033-2036
(717) 531-5638
(717) 531-0983
Mailing address
PO BOX 858, MC A410, HERSHEY, PA 17033-0858
(800) 243-1455
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
2015-00478
NC
207X00000X
Orthopaedic Surgery Physician
MT196612
PA
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
MD447323
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1032342850002
—
PA
05
—
1518287010
—
NC
05
—
NC2429
—
SC
Enumeration date
06/07/2010
Last updated
10/16/2017
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