Organization
UNDERWOOD-MEMORIAL HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD SHIELDS (DIRECTOR OF PRACTICE MANAGEMENT)
(856) 845-0100
Entity
Organization
Contact information
Practice address
1120 DELSEA DR N, GLASSBORO, NJ 08028-1444
(856) 582-0500
(856) 582-0163
Mailing address
1120 DELSEA DR N, GLASSBORO, NJ 08028-1444
(856) 582-0500
(856) 582-0163
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6987508
—
NJ
Enumeration date
11/17/2006
Last updated
04/22/2008
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