Healthcare Provider Details

I. General information

NPI: 1487901633
Provider Name (Legal Business Name): FRANK OWARE DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2012
Last Update Date: 06/15/2020
Certification Date: 06/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 KINGS WAY E SUITE D6
SEWELL NJ
08080-2237
US

IV. Provider business mailing address

100 KINGS WAY E SUITE D6
SEWELL NJ
08080-2237
US

V. Phone/Fax

Practice location:
  • Phone: 856-506-2950
  • Fax: 856-582-6083
Mailing address:
  • Phone: 856-506-2950
  • Fax: 856-582-6083

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number25MD00313800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: