Provider Demographics
NPI:1447801535
Name:ST. LUKE'S PHYSICIAN GROUP, INC
Entity Type:Organization
Organization Name:ST. LUKE'S PHYSICIAN GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ENROLLMENT SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:ELISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:AMEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-526-2538
Mailing Address - Street 1:CENTRAL VERIFICATION OFFICE
Mailing Address - Street 2:80 OSTRUM STREET
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015
Mailing Address - Country:US
Mailing Address - Phone:484-526-2538
Mailing Address - Fax:833-213-6428
Practice Address - Street 1:801 OSTRUM ST
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18015-1000
Practice Address - Country:US
Practice Address - Phone:484-526-2538
Practice Address - Fax:833-213-6428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-20
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty