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General NPI Number Information
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NPI Number | 1538192315
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Entity Type | Organization
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Legal Business Name | FAMILY MEDICINE OF LIONVILLE LLC
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 02/16/2010
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Provider Practice Location Address
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Address Line | 529 WEST UWCHLAN AVENUE
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City | LIONVILLE
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State | PA
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Zip | 19353-0481
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Country | US
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Telephone | 610-363-7303
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Fax | 610-524-4718
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Provider Business Mailing Address
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Address Line | PO BOX 481RTE 113
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City | LIONVILLE
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State | PA
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Zip | 19353-0481
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Country | US
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Telephone | 610-363-7303
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Fax | 610-524-4718
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Authorized Official
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Title or Position | MEMBER
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Name | DR. EARL R. TRIEVEL
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Credential | D.O.
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Telephone | 610-363-7559
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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 | OS002581L
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License Number State | PA
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