Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | MC004884 | NJ |
NPI | 1336269281 |
---|---|
Provider Name | Dr. Michael J Master |
First Address | Sewell, NJ 08080-2337 |
Second Address | Sewell, NJ 08080-2337 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2007 |
Last Update Date | 08/07/2007 |