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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 Fogelsville Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
DEAN W EVANS (PRESIDENT)
(484) 526-4911
Entity
Organization
Contact information
Practice address
1251 TURNSTONE DRIVE, SUITE 120, FOGELSVILLE, PA 18051-1713
(484) 822-5150
(484) 822-5160
Mailing address
801 OSTRUM ST, BETHLEHEM, PA 18015-1000
(610) 336-4676
(833) 821-0341
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
686024
MEDICARE GROUP
PA
Enumeration date
04/18/2016
Last updated
04/03/2019
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