Healthcare Provider Details

I. General information

NPI: 1487653770
Provider Name (Legal Business Name): JOEL NAMM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1255 WHITEHORSE MERCERVILLE RD SUITE 514
HAMILTON NJ
08619-3800
US

IV. Provider business mailing address

3625 QUAKERBRIDGE RD
HAMILTON NJ
08619-1207
US

V. Phone/Fax

Practice location:
  • Phone: 609-585-8800
  • Fax: 609-585-1825
Mailing address:
  • Phone: 609-689-1600
  • Fax: 609-689-1200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License NumberMA02456600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: