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Organization
ST LUKE'S PHYSICIAN GROUP INC
Active
Organization
ST LUKE'S PHYSICIAN GROUP INC
Active
Other names
St. Luke's OMS
Organization subpart
No
Provider details
NPI number
Authorized official
SUE CHIAVAROLI (ENROLLMENT MANAGER)
(484) 526-3569
Entity
Organization
Contact information
Practice address
1521 8TH AVE, SUITE 100, BETHLEHEM, PA 18018-1865
(610) 865-8077
(610) 865-8112
Mailing address
801 OSTRUM ST, BETHLEHEM, PA 18015-1000
(484) 526-4000
(610) 865-8112
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
06/06/2006
Last updated
09/13/2023
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