Healthcare Provider Details

I. General information

NPI: 1023103884
Provider Name (Legal Business Name): STEPHEN JUSTIN SZAWLEWICZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 01/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 TRENTON ROAD
BROWNS MILLS NJ
08015
US

IV. Provider business mailing address

200 TRENTON ROAD
BROWNS MILLS NJ
08015
US

V. Phone/Fax

Practice location:
  • Phone: 609-893-6611
  • Fax: 609-893-6038
Mailing address:
  • Phone: 609-893-6611
  • Fax: 609-893-6038

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMA070998
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number25MA07099800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: