Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | C1-0023825 | DE |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | MD422655 | PA |
NPI | 1174514962 |
---|---|
Provider Name | James A Tom |
First Address | Moorestown, NJ 08057-3963 |
Second Address | Moorestown, NJ 08057-3963 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2005 |
Last Update Date | 31/01/2022 |