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General NPI Number Information
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NPI Number | 1790253904
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Entity Type | Organization
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Legal Business Name | LEHIGH VALLEY PHYSICIAN GROUP
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Dates
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Enumeration Date | 11/06/2018
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Last Update Date | 11/06/2018
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Provider Practice Location Address
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Address Line | 4263 LONAT DRIVE
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City | NAZARETH
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State | PA
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Zip | 18064-8403
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Country | US
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Telephone | 610-572-2296
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Fax |
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Provider Business Mailing Address
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Address Line | 1605 N CEDAR CREST BLVD STE 110
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City | ALLENTOWN
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State | PA
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Zip | 18104-2351
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Country | US
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Telephone | 610-973-1400
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Fax | 610-973-1450
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Authorized Official
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Title or Position | MANAGER INSURANCE ENROLLMENT
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Name | MICHELLE L FOEHRKOLB
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Credential |
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Telephone | 484-884-0720
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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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