Healthcare Provider Details

I. General information

NPI: 1407530801
Provider Name (Legal Business Name): ANA TEGTMEIER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2023
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2550 ROUTE 100 STE 200
MACUNGIE PA
18062-9600
US

IV. Provider business mailing address

2550 ROUTE 100 STE 200
MACUNGIE PA
18062-9600
US

V. Phone/Fax

Practice location:
  • Phone: 610-628-7111
  • Fax:
Mailing address:
  • Phone: 610-628-7111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD495203
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: