Organization
CHRISTIAN MEDICAL CENTRE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WAYNE A SHAW MD (OWNER)
(609) 469-4673
Entity
Organization
Contact information
Practice address
897 PARKWAY AVE, EWING, NJ 08618-2305
(856) 344-9009
(856) 997-9262
Mailing address
897 PARKWAY AVE, EWING, NJ 08618-2305
(856) 344-9009
(856) 997-9262
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
25MA091266300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0302457
—
NJ
Enumeration date
09/09/2016
Last updated
09/09/2016
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