Healthcare Provider Details

I. General information

NPI: 1548671159
Provider Name (Legal Business Name): FAHD M MOEEZ DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2014
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 BERLIN RD STE 5000
CHERRY HILL NJ
08034-3573
US

IV. Provider business mailing address

52 BERLIN RD STE 5000
CHERRY HILL NJ
08034-3573
US

V. Phone/Fax

Practice location:
  • Phone: 856-795-1003
  • Fax: 856-795-5994
Mailing address:
  • Phone: 856-795-1003
  • Fax: 856-795-5994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number25MD00334200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: