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NPI Code Detail

MEDICARE: NANCY SUSAN STORY M.D.

MEDICARE: NANCY SUSAN STORY M.D.
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
1207QG0300XGeriatric Medicine (Family Medicine) PhysicianMD022305EPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1962402651
Entity Type Code : Individual
Provider Name (Legal Business Name) : NANCY SUSAN STORY M.D.
Provider Business Mailing Address
First Line : 2140 WARRENSVILLE RD
Second Line :
City : MONTOURSVILLE
State : PA
Zip : 17754-9621
Country : US
Telephone Number : 570-433-3161
Fax Number : 570-433-2611
Provider Business Practice Location Address
First Line : 2140 WARRENSVILLE RD
Second Line :
City : MONTOURSVILLE
State : PA
Zip : 17754-9621
Country : US
Telephone Number : 570-433-3161
Fax Number : 570-433-2611
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2005
Last Update Date : 07/13/2007

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