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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 Trauma Associates
Organization subpart
No
Provider details
NPI number
Authorized official
SUE CHIAVAROLI (CVO SUPERVISOR)
(484) 526-3569
Entity
Organization
Contact information
Practice address
801 OSTRUM ST, BETHLEHEM, PA 18015-1000
(484) 526-2200
(484) 526-6459
Mailing address
801 OSTRUM ST, BETHLEHEM, PA 18015-1000
(484) 526-2200
(484) 526-6459
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
NULL
207P00000X
Emergency Medicine Physician
—
—
2086S0102X
Surgical Critical Care Physician
—
NULL
2086S0102X
Surgical Critical Care Physician
—
—
2086S0127X
Trauma Surgery Physician
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007307530035
—
PA
Enumeration date
11/22/2006
Last updated
08/25/2021
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