# ST LUKE'S PHYSICIAN GROUP, INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ST LUKE'S PHYSICIAN GROUP, INC
- **Other names:** St. Luke's Surgical Advanced Practice Services
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1598417404
- **Legal business name:** ST LUKE'S PHYSICIAN GROUP, INC
- **Authorized official:** ELISHA AMEY (PROVIDER ENROLLMENT SPECIALIST)
- **Authorized official phone:** (484) 526-2538

## Contact information

- **Practice address:** 801 OSTRUM ST, BETHLEHEM, PA 18015-1000
- **Practice address phone:** (484) 526-4641
- **Practice address fax:** (484) 526-3028
- **Mailing address:** 801 OSTRUM ST, BETHLEHEM, PA 18015-1000
- **Mailing address phone:** (484) 526-2538

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363AS0400X | Surgical Physician Assistant | — | NULL | Yes |
| 363AS0400X | Surgical Physician Assistant | — | — | Yes |

## Other

- **Enumeration date:** 01/21/2022
- **Last updated:** 01/21/2022