Individual
TAMARA ANNE LACOUTURE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
900 MEDICAL CENTER DR STE 100, SEWELL, NJ 08080
(856) 582-3008
Mailing address
900 MEDICAL CENTER DR STE 100, SEWELL, NJ 08080-2358
(856) 582-3008
Taxonomy
Speciality
Code
Description
License number
State
2085R0203X
Therapeutic Radiology Physician
Primary
25MA06314000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7990405
—
NJ
Enumeration date
07/05/2005
Last updated
02/10/2020
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