Individual
KEITH BUMEDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
207 W FULTON ST, EPHRATA, PA 17522-1902
(717) 721-8789
(717) 715-1360
Mailing address
3421 CONCORD RD, YORK, PA 17402-9001
(717) 721-8789
(717) 715-1360
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA054613
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1032012750001
—
PA
Enumeration date
09/15/2010
Last updated
11/04/2021
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