MEDICARE: MEDICAL ASSOCIATES OF THE LEHIGH VALLEY PC

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	50046209	OTHER	PA	CAPITAL BLUE CROSS
2	CA1229	OTHER	PA	PALMETTO RR
3	1697624	OTHER	PA	HIGHMARK PA BLUE SHIELD

General Provider Information

NPI Number	:	1710933023
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL ASSOCIATES OF THE LEHIGH VALLEY PC

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	:	610-973-1400
Fax Number	:	610-973-1449

Provider Business Practice Location Address
First Line	:	6083 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	:	EXECUTIVE DIRECTOR
Name	:	ROBERT E STOVER
Credential	:
Telephone Number	:	610-973-1400

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	09/26/2011

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