=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770266439
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ASHLEE A LUDWIG PA-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/09/2023
-----------------------------------------------------
Last Update Date | 08/09/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2550 ROUTE 100 STE 220
-----------------------------------------------------
City | MACUNGIE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18062-9600
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-628-7111
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7 TINA LN
-----------------------------------------------------
City | MERTZTOWN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19539-9139
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363A00000X
-----------------------------------------------------
Taxonomy Name | Physician Assistant
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------