Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | MA04456 | NJ |
NPI | 1053346304 |
---|---|
Provider Name | Michael S Entmacher |
First Address | Mt Holly, NJ 08060 |
Second Address | Mt Holly, NJ 08060 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 30/10/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110046923 | RAILROAD MEDICARE (01) | |
33716 | AETNA (01) | |
4527101 | (05) | NJ |
A59618 | (02) |