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General NPI Number Information
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NPI Number | 1407840283
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Entity Type | Organization
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Legal Business Name | LEWISBURG PEDIATRICS
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Dates
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Enumeration Date | 09/07/2005
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Last Update Date | 10/06/2015
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Provider Practice Location Address
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Address Line | 55 MEDICAL PARK DR
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City | LEWISBURG
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State | PA
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Zip | 17837-6343
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Country | US
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Telephone | 570-523-3264
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Fax | 570-523-3465
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Provider Business Mailing Address
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Address Line | 55 MEDICAL PARK DR
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City | LEWISBURG
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State | PA
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Zip | 17837-6343
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Country | US
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Telephone | 570-523-3264
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Fax | 570-523-3465
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Authorized Official
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Title or Position | PEDIATRICIAN
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Name | DR. ELAM R STOLTZFUS
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Credential | M.D.
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Telephone | 570-523-3264
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State | PA
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