Individual
MOHAMED KAWAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
160 HALEDON AVE, PROSPECT PARK, NJ 07508-2051
(973) 942-3200
(973) 942-2901
Mailing address
PO BOX 3400, WAYNE, NJ 07474-3400
(973) 942-3200
(973) 942-2901
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25MA06054400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01000019400
AMERICHOICE#
NJ
01
—
0527024
AETNA HMO#
NJ
01
—
0551037000
AMERIHEALTH#
NJ
01
—
1081846
HORIZON NJ HEALTH#
NJ
01
—
12129
UNIVERSITY HEALTH PLANS #
NJ
01
—
12189
AMERIGROUP#
NJ
01
—
223521353
TAX ID#
NJ
01
—
395AD1
EMPIRE BC/BS NY
NJ
01
—
3K3301
HEALTHNET #
NJ
01
—
4592906
AETNA PPO#
NJ
01
—
5503390
GHI PPO#
NJ
05
—
6274501
—
NJ
01
—
P00311542
RR MDCR #
NJ
01
—
P2145955
OXFORD#
NJ
Enumeration date
12/08/2006
Last updated
10/09/2012
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