Organization
ST. LUKE'S PHYSICIAN GROUP, INC.
Active
Other names
St. Luke's Neurosurgical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEAN EVANS (PRESIDENT)
(610) 954-4991
Entity
Organization
Contact information
Practice address
701 OSTRUM ST, SUITE 302, FOUNTAIN HILL, PA 18015-1155
(484) 526-6000
(484) 526-9410
Mailing address
701 OSTRUM ST, SUITE 302, FOUNTAIN HILL, PA 18015-1155
(484) 526-6000
(484) 526-9410
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
2085N0700X
Neuroradiology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007307530101
—
PA
Enumeration date
05/25/2006
Last updated
10/06/2021
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