Individual
DR. LAWRENCE L ALTAKER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1013 MUMMA RD, SUITE 203, WORMLEYSBURG, PA 17043-1144
(717) 761-6147
(717) 731-8712
Mailing address
1013 MUMMA RD, SUITE 203, WORMLEYSBURG, PA 17043-1144
(717) 761-6147
(717) 731-8712
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD007139E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010017280002
—
PA
Enumeration date
11/25/2005
Last updated
07/08/2007
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