Healthcare Provider Details

I. General information

NPI: 1831437789
Provider Name (Legal Business Name): MICHAEL POPLAWSKI MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MICHAL POPLAWSKI

II. Dates (important events)

Enumeration Date: 01/28/2013
Last Update Date: 10/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 CHAPEL AVE W
CHERRY HILL NJ
08002-2048
US

IV. Provider business mailing address

2201 CHAPEL AVE W
CHERRY HILL NJ
08002-2048
US

V. Phone/Fax

Practice location:
  • Phone: 856-488-6500
  • Fax: 856-922-5109
Mailing address:
  • Phone: 856-488-6500
  • Fax: 856-922-5109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD459943
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number25MA10053600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: