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Organization

MARK P SHAMPAIN MD PC

Active
Other names
Shampain & Associates
Organization subpart
No

Provider details

NPI number
Authorized official
MARK P SHAMPAIN MD (OWNER)
(610) 820-7611
Entity
Organization

Contact information

Practice address
3131 COLLEGE HEIGHTS BLVD, SUITE 200, ALLENTOWN, PA 18104
(610) 820-7611
(610) 820-9884
Mailing address
3131 COLLEGE HEIGHTS BLVD, SUITE 200, ALLENTOWN, PA 18104
(610) 820-7611
(610) 820-9884

Taxonomy

Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001693052000
MEDICAL ASSISTANCE
PA
05
08418110001
PA
Enumeration date
05/26/2006
Last updated
07/14/2010
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