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General NPI Number Information
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NPI Number | 1669633830
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Entity Type | Organization
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Legal Business Name | LANCASTER CARDIOLOGY GROUP, LLC
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Dates
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Enumeration Date | 06/20/2008
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Last Update Date | 06/20/2008
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Provider Practice Location Address
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Address Line | 1821 OREGON PIKE SUITE 2
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City | LANCASTER
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State | PA
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Zip | 17601-6466
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Country | US
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Telephone | 717-569-7100
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Fax |
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Provider Business Mailing Address
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Address Line | 1821 OREGON PIKE SUITE 2
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City | LANCASTER
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State | PA
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Zip | 17601-6466
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Country | US
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Telephone | 717-569-7100
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Fax |
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Authorized Official
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Title or Position | CARDIOLOGIST/INTERNALIST
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Name | BERTRAM L JOHNSON
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Credential | M.D.
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Telephone | 717-569-7100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | PA
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