# ST LUKE'S PHYSICIAN GROUP INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** St. Luke's OMS
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033158910
- **Authorized official:** SUE CHIAVAROLI (ENROLLMENT MANAGER)
- **Authorized official phone:** (484) 526-3569

## Contact information

- **Practice address:** 1521 8TH AVE, SUITE 100, BETHLEHEM, PA 18018-1865
- **Practice address phone:** (610) 865-8077
- **Practice address fax:** (610) 865-8112
- **Mailing address:** 801 OSTRUM ST, BETHLEHEM, PA 18015-1000
- **Mailing address phone:** (484) 526-4000
- **Mailing address fax:** (610) 865-8112

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 06/06/2006
- **Last updated:** 09/13/2023