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General NPI Number Information
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NPI Number | 1053346304
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Entity Type | Individual
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Provider Name | MICHAEL S ENTMACHER MD
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Gender | Male
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 10/30/2009
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Provider Practice Location Address
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Address Line | 175 MADISON AVENUE 4TH FLOOR STOKES BUILDING
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City | MT HOLLY
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State | NJ
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Zip | 08060
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Country | US
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Telephone | 609-702-1900
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Fax | 609-702-8455
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Provider Business Mailing Address
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Address Line | 175 MADISON AVENUE 4TH FLOOR STOKES BUILDING
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City | MT HOLLY
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State | NJ
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Zip | 08060
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Country | US
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Telephone | 609-702-1900
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Fax | 609-702-8455
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | MA04456
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License Number State | NJ
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