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General NPI Number Information
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NPI Number | 1114971553
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Entity Type | Organization
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Legal Business Name | LMG FAMILY PRACTICE PC
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Dates
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Enumeration Date | 05/20/2006
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Last Update Date | 05/22/2015
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Provider Practice Location Address
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Address Line | 1019 S BROAD ST
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City | LANSDALE
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State | PA
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Zip | 19446-5338
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Country | US
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Telephone | 215-361-5090
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Fax | 215-412-4296
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Provider Business Mailing Address
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Address Line | 1019 S BROAD ST
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City | LANSDALE
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State | PA
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Zip | 19446-5338
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Country | US
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Telephone | 215-361-5090
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Fax | 215-412-4296
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Authorized Official
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Title or Position | PRESIDENT
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Name | LINDA NADWODNY
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Credential | DO
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Telephone | 215-361-5090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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