Provider Demographics
NPI:1548254816
Name:DUNMORE, ELIZABETH WITMER (MD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:WITMER
Last Name:DUNMORE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1086 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15905-4305
Mailing Address - Country:US
Mailing Address - Phone:814-410-8300
Mailing Address - Fax:814-410-8331
Practice Address - Street 1:1086 FRANKLIN ST
Practice Address - Street 2:BLDG E, 3RD FLOOR
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15905-4305
Practice Address - Country:US
Practice Address - Phone:814-410-8300
Practice Address - Fax:814-410-8331
Is Sole Proprietor?:No
Enumeration Date:2005-09-01
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD053089207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001464210Medicaid
PA079367OtherPREFERRED/AMERI HEALTH
PA28767OtherHEALTH AM/HEALTH ASSUR
12876W420OtherGEISINGER
PA110235574OtherRR MEDICARE
PADU079367OtherHIGHMARK
PA309966OtherUPMC
PADU079367OtherHIGHMARK
PA309966OtherUPMC