Healthcare Provider Details

I. General information

NPI: 1427292002
Provider Name (Legal Business Name): LEHIGH VALLEY PHYSICIAN GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2009
Last Update Date: 10/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

940 N NEW ST
BETHLEHEM PA
18018-2756
US

IV. Provider business mailing address

1605 N CEDAR CREST BLVD SUITE 110B
ALLENTOWN PA
18104-2351
US

V. Phone/Fax

Practice location:
  • Phone: 610-868-9411
  • Fax:
Mailing address:
  • Phone: 610-973-1410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL CALLAHAN
Title or Position: ASSOCIATE EXEC DIRECTOR OF FINANCE
Credential:
Phone: 610-798-4500