Individual
MIKEL SHEA EHNTHOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1600 HADDON AVE FL 6, CAMDEN, NJ 08103-3101
(856) 757-3500
Mailing address
301 LIPPINCOTT DR STE 410, MARLTON, NJ 08053-4197
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
25MA11936200
NJ
2084P0800X
Psychiatry Physician
25MA11936200
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/16/2016
Last updated
09/18/2024
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