Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 25MA06095700 | NJ |
NPI | 1013928647 |
---|---|
Provider Name | Mr. George Tweddel |
First Address | Warren, NJ 07059-5605 |
Second Address | Warren, NJ 07059-5605 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2006 |
Last Update Date | 28/02/2017 |