Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | MD02133 | NJ |
N | 222Z00000X | Podiatrist | MD02133 | NJ |
Y | 213ES0103X | Foot & Ankle Surgery | 25MD00213300 | NJ |
N | 213ES0103X | Foot & Ankle Surgery | MD02133 | NJ |
NPI | 1003875915 |
---|---|
Provider Name | Dr. Steven B Cancell |
First Address | Camden, NJ 08103-1088 |
Second Address | Marlton, NJ 08053-9644 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2006 |
Last Update Date | 21/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U34032 | (02) | NJ |