Healthcare Provider Details

I. General information

NPI: 1174672406
Provider Name (Legal Business Name): ATLANTICARE PHYSICIAN GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 CINCINNATI AVE
EGG HARBOR CITY NJ
08215-1926
US

IV. Provider business mailing address

2500 ENGLISH CREEK AVE BUILDING B
EGG HARBOR TOWNSHIP NJ
08234-5549
US

V. Phone/Fax

Practice location:
  • Phone: 609-390-7814
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. DONALD PARKER
Title or Position: PRESIDENT & CEO
Credential:
Phone: 609-272-6393