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Individual

DR. PAUL GARRETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
18 FAIRVIEW RD, MEDFORD, NJ 08055-9116
(609) 463-4003
Mailing address
18 FAIRVIEW RD, MEDFORD, NJ 08055-9116

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MA04963700
NJ
2085R0202X
Diagnostic Radiology Physician
MD028592E
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00644550000
AMERIHEALTH
NJ
01
106716
KEYSTONE
NJ
05
7413106
NJ
Enumeration date
09/26/2006
Last updated
07/08/2007
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