Individual
DR. SHAHRAM JAY MIRMANESH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MBA
Contact information
Practice address
12000 LINCOLN DR W, SUITE 311, MARLTON, NJ 08053-3402
(856) 985-8100
(856) 985-8374
Mailing address
3 WOODBROOK RD, VOORHEES, NJ 08043-2840
(856) 768-5336
(856) 985-8374
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MA05186900
NJ
Other
Enumeration date
05/19/2006
Last updated
07/08/2007
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