Organization
ROWANSOM NMI ORTHOPEDICS SPORTS MED
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 E LAUREL RD, SUITE 1700, STRATFORD, NJ 08084-1354
(856) 566-7010
(856) 566-6956
Mailing address
42 E LAUREL RD, SUITE 1700, STRATFORD, NJ 08084-1354
(856) 566-7010
(856) 566-6956
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0431561000
AMERIHEALTH
NJ
05
—
3394107
—
NJ
01
—
42823
AETNA
NJ
01
—
DD5957
RAILROAD MEDICARE
NJ
Enumeration date
01/30/2006
Last updated
05/03/2013
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