Provider Demographics
NPI:1205898996
Name:MACUNGIE MEDICAL GROUP PC
Entity type:Organization
Organization Name:MACUNGIE MEDICAL GROUP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HAL
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:BENDIT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:610-966-4646
Mailing Address - Street 1:3760 BROOKSIDE RD
Mailing Address - Street 2:
Mailing Address - City:MACUNGIE
Mailing Address - State:PA
Mailing Address - Zip Code:18062-1741
Mailing Address - Country:US
Mailing Address - Phone:610-966-4646
Mailing Address - Fax:610-965-6201
Practice Address - Street 1:3760 BROOKSIDE RD
Practice Address - Street 2:
Practice Address - City:MACUNGIE
Practice Address - State:PA
Practice Address - Zip Code:18062-1741
Practice Address - Country:US
Practice Address - Phone:610-966-4646
Practice Address - Fax:610-965-6201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-06
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA02342600OtherCAPITAL BLUE CROSS
PA1924072OtherHIGHMARK BLUE SHIELD
PADN8982OtherRAILROAD MEDICARE
PA02342600OtherCAPITAL BLUE CROSS