| Organization Name: | ESBENSHADE MEDICAL CARE PC |
| NPI Number: | 1063649283 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SUSAN SLACK (MEDICAL BILLER) |
| Mailing Address: | 2615 Crabapple Cir Perkasie |
| State: | PA US |
| Postal Code: | 189445460 |
| Phone Number: | 2157033751 |
| Fax Number: | 2157033744 |
| NPI Enumeration Date: | 06/15/2009 |
| NPI Last Update Date: | 06/15/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207QA0505X |
| License Number: | MD069937L |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Family Medicine |
| Taxonomy Specialization: | Adult Medicine |
| Taxonomy Definition: | |