Healthcare Provider Details

I. General information

NPI: 1205898996
Provider Name (Legal Business Name): MACUNGIE MEDICAL GROUP PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2006
Last Update Date: 01/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3760 BROOKSIDE RD
MACUNGIE PA
18062-1741
US

IV. Provider business mailing address

3760 BROOKSIDE RD
MACUNGIE PA
18062-1741
US

V. Phone/Fax

Practice location:
  • Phone: 610-966-4646
  • Fax: 610-965-6201
Mailing address:
  • Phone: 610-966-4646
  • Fax: 610-965-6201

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: DR. HAL SCOTT BENDIT
Title or Position: PARTNER
Credential: D.O.
Phone: 610-966-4646