MEDICARE: LEHIGH VALLEY PHYSICIAN GROUP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1629212311
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEHIGH VALLEY PHYSICIAN GROUP

Provider Business Mailing Address
First Line	:	1605 N CEDAR CREST BLVD
Second Line	:	SUITE 110B
City	:	ALLENTOWN
State	:	PA
Zip	:	18104-2351
Country	:	US
Telephone Number	:	610-973-1410
Fax Number	:	610-973-1449

Provider Business Practice Location Address
First Line	:	6081 HAMILTON BLVD
Second Line	:
City	:	WESCOSVILLE
State	:	PA
Zip	:	18106-9767
Country	:	US
Telephone Number	:	610-395-0600
Fax Number	:	610-395-9473

Authorized Official
Title or Position	:	ASSOCIATE EXECUTIVE DIRECTOR OF FIN
Name	:	MICHAEL CALLAHAN
Credential	:
Telephone Number	:	610-798-4500

Provider Enumeration Date	:	04/24/2009
Last Update Date	:	10/14/2019

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Directions to “LEHIGH VALLEY PHYSICIAN GROUP ” Practice Location

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