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General NPI Number Information
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NPI Number | 1770556573
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Entity Type | Organization
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Legal Business Name | SHAWNEE MEDICAL GROUP, P.C.
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Dates
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Enumeration Date | 02/10/2006
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Last Update Date | 02/12/2013
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Provider Practice Location Address
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Address Line | BUTTERMILK FALLS ROAD
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City | SHAWNEE-ON-DELAWARE
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State | PA
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Zip | 18356-0244
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Country | US
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Telephone | 570-421-3900
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Fax | 570-424-1549
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Provider Business Mailing Address
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Address Line | PO BOX 244
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City | SHAWNEE ON DELAWARE
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State | PA
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Zip | 18356-0244
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Country | US
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Telephone | 570-421-3900
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Fax | 570-424-1549
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. WANITA ANN SATTERFIELD
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Credential |
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Telephone | 570-421-4759
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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 | MD031607E
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License Number State | PA
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