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General NPI Number Information
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NPI Number | 1417190307
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Entity Type | Organization
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Legal Business Name | MEDICAL ASSOCIATES OF THE LEHIGH VALLEY PC
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Dates
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Enumeration Date | 04/08/2009
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Last Update Date | 04/08/2009
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Provider Practice Location Address
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Address Line | 4 W MAIN ST
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City | MACUNGIE
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State | PA
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Zip | 18062-1120
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Country | US
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Telephone | 610-967-4993
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Fax | 610-967-6553
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Provider Business Mailing Address
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Address Line | 1901 W HAMILTON ST SUITE 100B
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City | ALLENTOWN
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State | PA
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Zip | 18104-6459
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Country | US
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Telephone | 610-973-1410
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Fax | 610-973-1449
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. ROBERT E STOVER
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Credential |
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Telephone | 610-973-1400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | OS009668L
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License Number State | PA
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