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General NPI Number Information
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NPI Number | 1033561972
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Entity Type | Organization
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Legal Business Name | ALLENTOWN MEDICAL CLINIC INC
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Dates
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Enumeration Date | 07/03/2016
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Last Update Date | 07/07/2016
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Provider Practice Location Address
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Address Line | 221 N CEDAR CREST BLVD
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City | ALLENTOWN
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State | PA
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Zip | 18104-4603
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Country | US
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Telephone | 610-457-5090
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 727
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City | WHITEHALL
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State | PA
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Zip | 18052-0727
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SAMER SHAMSI BASHA
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Credential | M.D.
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Telephone | 610-457-5090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | MD417375
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License Number State | PA
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