Provider Demographics
NPI:1902916984
Name:GARTLAND, CHARLES J (DO)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:J
Last Name:GARTLAND
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:1803 MOUNT ROSE AVE
Mailing Address - Street 2:SUITE B3
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-3026
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:717-812-2163
Practice Address - Street 1:300 PINE GROVE COMMONS
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-5176
Practice Address - Country:US
Practice Address - Phone:717-812-2143
Practice Address - Fax:717-812-2163
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS005851L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA30123003 - RDYCAREOtherAMERIHEALTH MERCY - WMG
PA30100250OtherAMERIHEALTH MERCY-WMG
PA145795OtherHIGHMARK BLUE SHIELD
PA30123001 - CAREEXP.OtherAMERIHEALTH MERCY - WMG
MD974202OtherCAREFIRST MD
PA001160920Medicaid
PA417112OtherUPMC
PAP010507OtherGATEWAY
MD974202OtherCAREFIRST MD
PA145795FLTMedicare PIN
PA30123001 - CAREEXP.OtherAMERIHEALTH MERCY - WMG