Individual
DR. MANOJ PRAKASH JAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 BOWMAN DR LOWR LEVEL1, VOORHEES, NJ 08043
(856) 247-3000
(856) 247-2597
Mailing address
2000 CRAWFORD PL STE 200, MOUNT LAUREL, NJ 08054-3954
(856) 355-0340
(856) 355-0330
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0000000000
NJ
208M00000X
Hospitalist Physician
Primary
25MA08285100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0223158
—
NJ
01
—
3763058000
AMERIHEALTH
NJ
Enumeration date
05/10/2007
Last updated
10/20/2020
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