Healthcare Provider Details

I. General information

NPI: 1609802057
Provider Name (Legal Business Name): NAUMAN A DIWAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 04/30/2021
Certification Date: 04/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1445 WHITEHORSE MERCERVILLE RD STE 103
HAMILTON NJ
08619-3834
US

IV. Provider business mailing address

1235 WHITEHORSE MERCERVILLE RD STE 306
HAMILTON NJ
08619-3810
US

V. Phone/Fax

Practice location:
  • Phone: 609-587-6661
  • Fax: 609-528-8891
Mailing address:
  • Phone: 609-581-9000
  • Fax: 609-585-7228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number25MA06535300
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA06535300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: