Organization
CMC DEPARTMENT OF MEDCINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT MCMULLEN (EVP MANAGED CARE)
(856) 342-2921
Entity
Organization
Contact information
Practice address
3 COOPER PLZ, SUITE 215 (NEUROLOGY), CAMDEN, NJ 08103-1438
(856) 342-2445
(856) 964-0504
Mailing address
3 COOPER PLZ, SUITE 502, CAMDEN, NJ 08103-1438
(856) 342-2921
(856) 968-8499
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2835974000
AMERIHEALTH GROUP#
NJ
Enumeration date
08/07/2007
Last updated
08/07/2007
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