Healthcare Provider Details

I. General information

NPI: 1265759252
Provider Name (Legal Business Name): RAWAHUDDIN NASEEM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2010
Last Update Date: 11/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 BOWMAN DR CHCA NJ EMERGENCY MEDICINE @ VIRTUA
VOORHEES NJ
08043-9612
US

IV. Provider business mailing address

100 E PENN SQ FL 9 CHCA NJ EMERGENCY MEDICINE
PHILADELPHIA PA
19107-3377
US

V. Phone/Fax

Practice location:
  • Phone: 856-325-3000
  • Fax: 609-261-5842
Mailing address:
  • Phone: 267-425-9232
  • Fax: 267-425-9299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License NumberMD454177
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MA09667200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: