Individual
CAROL LISA BUB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
619 DALTON ST, EMMAUS, PA 18049-3031
(610) 628-8200
(610) 965-6595
Mailing address
619 DALTON ST, EMMAUS, PA 18049-3031
(610) 628-8200
(610) 965-6595
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD059650L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016133000002
—
PA
Enumeration date
07/29/2005
Last updated
09/10/2012
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