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Organization
ROWANSOM DEPT OF MATERNAL-FETAL MEDICINE
Active
Organization
ROWANSOM DEPT OF MATERNAL-FETAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL RIEKER (INTERIM CHIEF FINANCIAL OFFICER)
(856) 770-5729
Entity
Organization
Contact information
Practice address
570 EGG HARBOR RD, SUITE C-2, SEWELL, NJ 08080-2359
(856) 218-0300
(856) 589-9487
Mailing address
570 EGG HARBOR RD, SUITE C-2, SEWELL, NJ 08080-2359
(856) 218-0300
(856) 589-9487
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0739469000
AMERIHEALTH
NJ
01
—
478591
AETNA
NJ
05
—
6304401
—
NJ
01
—
DQ4958
RR MEDICARE
NJ
Enumeration date
01/20/2006
Last updated
05/03/2013
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