MEDICARE: ST. LUKE'S PHYSICIAN GROUP, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician		PA

General Provider Information

NPI Number	:	1275636185
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ST. LUKE'S PHYSICIAN GROUP, INC.

Provider Business Mailing Address
First Line	:	801 OSTRUM ST
Second Line	:
City	:	BETHLEHEM
State	:	PA
Zip	:	18015-1000
Country	:	US
Telephone Number	:	484-526-6048
Fax Number	:	484-526-6500

Provider Business Practice Location Address
First Line	:	111 ROUTE 715 STE 101
Second Line	:
City	:	BRODHEADSVILLE
State	:	PA
Zip	:	18322-7101
Country	:	US
Telephone Number	:	272-212-0435
Fax Number	:	272-212-0437

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DEAN W EVANS
Credential	:
Telephone Number	:	484-526-4911

Provider Enumeration Date	:	09/06/2006
Last Update Date	:	01/17/2018

Similar Medicare Providers

1922384957 — CYNTHIA MARIE VENTRE CRNP
Practice Location Address:

111 ROUTE 715
BRODHEADSVILLE, PA
18322-7101

Practice Phone: 272-212-0435
Practice Fax: 866-230-8056

1609817469 — MS. STUTI Y. NAIK PA-C
Practice Location Address:

111 ROUTE 715 STE 100
BRODHEADSVILLE, PA
18322-7101

Practice Phone: 272-212-0420
Practice Fax: 732-744-5614

1073914180 — SAMANTHA GAMBLER PA-C
Practice Location Address:

111 ROUTE 715 STE 102
BRODHEADSVILLE, PA
18322-7101

Practice Phone: 272-212-0420
Practice Fax:

1346692811 — MARGARET MINTUS D.O.
Practice Location Address:

111 ROUTE 715
BRODHEADSVILLE, PA
18322-7101

Practice Phone: 272-212-0435
Practice Fax: 866-230-8056

1831618560 — ST. LUKE'S HOSPITAL MONROE CAMPUS
Practice Location Address:

111 ROUTE 715 STE 102
BRODHEADSVILLE, PA
18322-7101

Practice Phone: 272-212-0420
Practice Fax: 272-212-0422

1851874549 — KYLE PANE PA
Practice Location Address:

111 ROUTE 715 STE 100
BRODHEADSVILLE, PA
18322-7101

Practice Phone: 272-212-0426
Practice Fax: 607-729-3982

Directions to “ST. LUKE'S PHYSICIAN GROUP, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.