Integrated Medical Group, P.C.
Family Medicine in Boyertown, PA. Organization (NPI-2).
NPI number1336740976
StatusActive
Last updated in NPPESNov 2, 2020
Details
- NPI
- 1336740976
- Entity type
- Organization (NPI-2)
- Legal business name
- Integrated Medical Group, P.C.
- Organization subpart
- No
- Enumeration date
- Nov 2, 2020
- Certification date
- Nov 2, 2020
- Last updated
- Nov 2, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
| 207QS0010X | Family Medicine, Sports Medicine | – | – |
Practice location
23 N Walnut StBoyertown, PA 19512-1736
Phone 610-396-5163 · Fax 570-624-4778
Mailing address
82 Tunnel RdPottsville, PA 17901-3869
Phone 570-622-5455 · Fax 570-622-5493
Authorized official
Kimberly Walsh
Director Of Operations
5706225455
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