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Organization
ST. LUKE'S PHYSICIAN GROUP, INC
Active
Organization
ST. LUKE'S PHYSICIAN GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEAN W. EVANS (PRESIDENT)
(484) 526-4991
Entity
Organization
Contact information
Practice address
2599 STATE ROUTE 903, ALBRIGHTSVILLE, PA 18210
(570) 645-1945
(570) 645-1946
Mailing address
2599 STATE ROUTE 903, ALBRIGHTSVILLE, PA 18210-3756
(570) 645-1945
(570) 645-1946
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
686024
MEDICARE GROUP
PA
Enumeration date
07/28/2015
Last updated
02/07/2018
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