Individual
JEFFREY M MAZURE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
15 E REDMAN AVE STE A, HADDONFIELD, NJ 08033-2316
(856) 428-1335
(856) 428-1330
Mailing address
400 LAUREL OAK RD STE 105, VOORHEES, NJ 08043-4455
(856) 922-9894
(856) 922-9890
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MB74824
NJ
207Q00000X
Family Medicine Physician
OS-013105
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1022848140001
—
PA
05
—
1022848140002
—
PA
01
—
CD4829
RR MEDICARE GROUP
PA
Enumeration date
06/07/2006
Last updated
09/27/2019
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