Organization
INTERMED PHYSICIANS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLE CHAPPLE (OFFICE MANAGER)
(570) 735-7474
Entity
Organization
Contact information
Practice address
4 E MAIN ST, NANTICOKE, PA 18634-1602
(570) 735-7474
(570) 735-2921
Mailing address
4 E MAIN ST, NANTICOKE, PA 18634-1602
(570) 735-7474
(570) 735-2921
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001819216 0005
—
PA
01
—
200174
BLACK LUNG
PA
01
—
890390
HIGHMARK BLUE SHIELD
PA
01
—
E163
GEISINGER HEALTH PLAN
PA
Enumeration date
05/18/2006
Last updated
04/09/2008
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