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Organization
ROWANSOM NMI ORTHOPEDICS SPORTS MED
Active
Organization
ROWANSOM NMI ORTHOPEDICS SPORTS MED
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
42 E LAUREL RD, SUITE 1700, STRATFORD, NJ 08084-1354
(856) 566-7010
(856) 566-6956
Mailing address
42 E LAUREL RD, SUITE 1700, STRATFORD, NJ 08084-1354
(856) 566-7010
(856) 566-6956
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
NULL
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0431561000
AMERIHEALTH
NJ
05
—
3394107
—
NJ
01
—
42823
AETNA
NJ
01
—
DD5957
RAILROAD MEDICARE
NJ
Enumeration date
01/30/2006
Last updated
05/03/2013
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