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Organization
ROWANSOM DEPT OF GENERAL INTERNAL MEDICINE
Active
Organization
ROWANSOM DEPT OF GENERAL INTERNAL 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
42 LAUREL RD E, UDP, SUITE 3100, STRATFORD, NJ 08084-1354
(856) 566-6845
(856) 566-6342
Mailing address
PO BOX 635, BELLMAWR, NJ 08099-0635
(856) 770-5772
(856) 566-2797
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3152707
—
NJ
01
—
CN4488
RR MEDICARE
NJ
Enumeration date
01/20/2006
Last updated
05/03/2013
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