Organization
BRUCE M LIDSTON AND ALLEN B ETTENGER PARTNERS
Active
Other names
Huntingdon Pediatric Associates
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE M LIDSTON M.D. (PARTNER)
(814) 643-0531
Entity
Organization
Contact information
Practice address
1227 WARM SPRINGS AVE STE 301, HUNTINGDON, PA 16652-2300
(814) 643-0531
(814) 643-6637
Mailing address
1227 WARM SPRINGS AVE STE 301, HUNTINGDON, PA 16652-2300
(814) 643-0531
(814) 643-6637
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
MD016074E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006768160004
—
PA
05
—
0010017640004
—
PA
05
—
1007685540002
—
PA
Enumeration date
07/05/2006
Last updated
07/01/2008
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