Individual
HERMAN WALLACE BRUBAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12 ST PAUL DR STE 101, CHAMBERSBURG, PA 17201-1035
(717) 217-6760
(717) 217-6912
Mailing address
785 5TH AVE, SUITE 3, CHAMBERSBURG, PA 17201-4232
(717) 263-9555
(717) 217-4218
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD028694E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000908788
—
PA
01
—
080086589
RAILROAD MEDICARE
PA
01
—
120420409
DEPT OF LABOR
PA
01
—
122715
UNISON
PA
01
—
1806901
CAPITAL BLUECROSS
PA
01
—
247728
MAMSI
PA
01
—
25-1716306
MULTIPLAN/PHCS
PA
01
—
426224
HEALTH AMERICA
PA
01
—
4397945
AETNA NON-HMO
PA
01
—
666058
FIRST HEALTH
PA
01
—
842753
AETNA HMO
PA
01
—
867633
MEDICARE GROUP #
PA
01
—
BR426736
HIGHMARK BLUE SHIELD
PA
01
—
MD028694E
LICENSE
PA
01
—
P006020
GATEWAY
PA
Enumeration date
06/13/2005
Last updated
03/07/2023
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