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General NPI Number Information
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NPI Number | 1881178317
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Entity Type | Organization
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Legal Business Name | ST. LUKE'S PHYSICIAN GROUP, INC.
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Dates
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Enumeration Date | 09/20/2018
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Last Update Date | 09/20/2018
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Provider Practice Location Address
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Address Line | 543 INTERCHANGE RD
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City | KRESGEVILLE
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State | PA
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Zip | 18333-7728
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Country | US
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Telephone | 610-681-6800
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Fax | 610-681-6825
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Provider Business Mailing Address
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Address Line | 801 OSTRUM ST
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City | BETHLEHEM
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State | PA
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Zip | 18015-1000
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Country | US
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Telephone | 484-526-6048
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Fax | 833-213-6428
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Authorized Official
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Title or Position | MANAGER
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Name | KRISTIN KEMMERER
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Credential |
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Telephone | 484-526-2019
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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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