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NPI Code Detail

MEDICARE: TWIN RIVERS GASTROENTEROLOGY CENTER, INC

MEDICARE: TWIN RIVERS GASTROENTEROLOGY CENTER, 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
1207RG0100XGastroenterology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10497999OTHERPAAETNA
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
302300700OTHERPACAPITAL BLUE CROSS

General Provider Information

NPI Number : 1851343784
Entity Type Code : Organization
Provider Name (Legal Business Name) : TWIN RIVERS GASTROENTEROLOGY CENTER, INC
Provider Business Mailing Address
First Line : 20 COMMUNITY DR
Second Line :
City : EASTON
State : PA
Zip : 18045-2658
Country : US
Telephone Number : 610-258-6635
Fax Number : 610-258-2879
Provider Business Practice Location Address
First Line : 20 COMMUNITY DR
Second Line :
City : EASTON
State : PA
Zip : 18045-2658
Country : US
Telephone Number : 610-258-6635
Fax Number : 610-258-2879
Authorized Official
Title or Position : CEO
Name : DR. SHANKER MUKHERJEE
Credential : M.D.
Telephone Number : 610-258-6635
Provider Enumeration Date : 05/17/2006
Last Update Date : 08/22/2020

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1154543486 — TWIN RIVERS GASTROENTEROLOGY CENTER,INC
Practice Location Address:
20 COMMUNITY DR
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18045-2658
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Practice Fax: 610-258-2879

Directions to “TWIN RIVERS GASTROENTEROLOGY CENTER, INC ” Practice Location

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