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General NPI Number Information
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NPI Number | 1548311608
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Entity Type | Organization
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Legal Business Name | MYERSTOWN FAMILY PRACTICE PC
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 10/22/2020
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Provider Practice Location Address
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Address Line | 431 W LINCOLN AVE
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City | MYERSTOWN
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State | PA
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Zip | 17067-2328
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Country | US
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Telephone | 717-866-5755
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Fax |
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Provider Business Mailing Address
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Address Line | 431 W LINCOLN AVE
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City | MYERSTOWN
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State | PA
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Zip | 17067-2328
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Country | US
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Telephone | 717-866-5755
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MARY E BERGER
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Credential |
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Telephone | 717-866-5755
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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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