Individual
DR. PREM THAMMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
361 GARIBALDI AVE, LODI, NJ 07644-3709
(973) 773-3556
(973) 773-2337
Mailing address
361 GARIBALDI AVE, LODI, NJ 07644-3709
(973) 773-3556
(973) 773-2337
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25641
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1384400
—
NJ
Enumeration date
03/28/2006
Last updated
07/13/2010
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