Doctor Name: | HEIDI ELIZABETH BUBNASH STORER |
NPI Number: | 1093079097 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | D.O. |
License Number: | OT014645 |
Business Practice Address: | 1736 Hamilton St Allentown, PA - 181045656 |
Business Phone Number: | 6107708300 |
Business Fax Number: | |
Mailing Address: | 1501 Lehigh St, Suite 103 ALLENTOWN |
State: | PA |
Postal Code: | 181033880 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 06/25/2012 |
NPI Last Update Date: | 06/25/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | OT014645 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |