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Organization
SUSQUEHANNA PHYSICIAN SERVICES
Active
Organization
SUSQUEHANNA PHYSICIAN SERVICES
Active
Other names
Susquehanna Health Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MELISSA DAVIS (VP/COO)
(570) 320-7696
Entity
Organization
Contact information
Practice address
215 E WATER ST, MUNCY, PA 17756-8828
(570) 546-4040
(570) 546-4095
Mailing address
1201 GRAMPIAN BLVD, WILLIAMSPORT, PA 17701-1900
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
804626
HIGHMARK BLUE SHIELD
PA
Enumeration date
06/21/2006
Last updated
10/22/2015
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