Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | MA069153 | NJ |
NPI | 1073566303 |
---|---|
Provider Name | Dr. Jeffrey M Sumerson |
First Address | Moorestown, NJ 08057-1326 |
Second Address | Mount Laurel, NJ 08054-4100 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 20/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8636303 | (05) | NJ |
H33930 | (02) | NJ |