Individual
JUSTIN OVERCASH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
555 N DUKE ST, LANCASTER, PA 17602-2250
(717) 544-4900
(717) 544-5907
Mailing address
PO BOX 4216, LANCASTER, PA 17604-4216
(717) 394-6028
(717) 509-6362
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD464201
PA
390200000X
Student in an Organized Health Care Education/Training Program
MT202097
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103505815
—
PA
Enumeration date
06/19/2012
Last updated
01/15/2020
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