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Organization
SOUTHERN FAMILY MEDICINE LLC
Active
Organization
SOUTHERN FAMILY MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMY BETH PEDONE M.D. (CHIEF FINANCIAL OFFICER)
(717) 227-3800
Entity
Organization
Contact information
Practice address
16312 MOUNT AIRY RD, SHREWSBURY, PA 17361-1623
(717) 227-3800
(717) 227-3802
Mailing address
16312 MOUNT AIRY RD, SHREWSBURY, PA 17361-1623
(717) 227-3800
(717) 227-3802
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50036273
CAPITAL BLUE CROSS
PA
01
—
959ASO
CARE FIRST
PA
01
—
SO1624336
HIGHMARK BLUE SHIELD
PA
Enumeration date
08/19/2006
Last updated
07/21/2022
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