Healthcare Provider Details

I. General information

NPI: 1831146455
Provider Name (Legal Business Name): MEDICAL ASSOCIATES OF THE LEHIGH VALLEY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 09/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 MAIN ST
CATASAUQUA PA
18032-2646
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 610-264-0411
  • Fax: 610-264-8498
Mailing address:
  • Phone: 610-973-1400
  • Fax: 610-973-1449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT E STOVER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 610-973-1400