# ST LUKE'S PHYSICIAN GROUP INC

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

## Provider details

- **NPI number:** 1376003541
- **Authorized official:** SUE CHIAVAROLI (SUPERVISOR)
- **Authorized official phone:** (484) 526-3569

## Contact information

- **Practice address:** 303 W BROAD ST, BETHLEHEM, PA 18018-5526
- **Practice address phone:** (610) 865-0311
- **Practice address fax:** (610) 865-9458
- **Mailing address:** 801 OSTRUM ST, BETHLEHEM, PA 18015-1000
- **Mailing address phone:** (484) 526-3569

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213E00000X | Podiatrist | — | NULL | — |
| 213E00000X | Podiatrist | — | — | — |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | Yes |

## Other

- **Enumeration date:** 03/22/2019
- **Last updated:** 08/25/2021