Basic Information
| Provider Information | |||||||||
| NPI: | 1568705119 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MUNCEE EMERGENCY PHYSICIANS, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 WITMER RD | ||||||||
| Address2: | STE 220 | ||||||||
| City: | HORSHAM | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190442291 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2154425146 | ||||||||
| FaxNumber: | 2159572875 | ||||||||
| Practice Location | |||||||||
| Address1: | 215 E WATER ST | ||||||||
| Address2: | |||||||||
| City: | MUNCY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 177568828 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2154425146 | ||||||||
| FaxNumber: | 2159572875 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/02/2013 | ||||||||
| LastUpdateDate: | 04/02/2013 | ||||||||
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| AuthorizedOfficialLastName: | MAYER | ||||||||
| AuthorizedOfficialFirstName: | THOM | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2154425146 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.