Healthcare Provider Details

I. General information

NPI: 1205910676
Provider Name (Legal Business Name): CUMBERLAND ORTHOPEDIC PROFESSIONAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 11/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2848 S DELSEA DR BLDG 1
VINELAND NJ
08360-7042
US

IV. Provider business mailing address

2848 S DELSEA DR BLDG 1
VINELAND NJ
08360-7042
US

V. Phone/Fax

Practice location:
  • Phone: 856-696-2010
  • Fax: 856-696-3689
Mailing address:
  • Phone: 856-696-2010
  • Fax: 856-696-3689

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: WINFIELD SCOTT WILLIAMS
Title or Position: PRESIDENT
Credential: MD
Phone: 856-696-2010