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Organization
PENN MEDICAL GROUP, P.C.
Active
Organization
PENN MEDICAL GROUP, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER J BADDICK III D.O. (OWNER, EXECUTIVE DIRECTOR)
(570) 386-4171
Entity
Organization
Contact information
Practice address
780 N KROCKS RD STE 101A, ALLENTOWN, PA 18106-9075
(610) 365-3354
Mailing address
780 N KROCKS RD STE 101A, ALLENTOWN, PA 18106-9075
(610) 365-3354
(610) 365-3361
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015989840002
—
PA
05
—
0019475840006
—
PA
01
—
1215993928
DR. BADDICK NPI
PA
01
—
1629038468
DR. OGBOLU NPI
PA
Enumeration date
01/23/2007
Last updated
11/19/2019
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