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General NPI Number Information
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NPI Number | 1083003982
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Entity Type | Organization
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Legal Business Name | ST. JOHN EMERGENCY SERVICES PC
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Dates
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Enumeration Date | 01/15/2015
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Last Update Date | 01/15/2015
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Provider Practice Location Address
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Address Line | 22101 MOROSS RD
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City | DETROIT
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State | MI
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Zip | 48236-2148
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Country | US
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Telephone | 856-686-4304
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Fax | 865-560-7078
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Provider Business Mailing Address
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Address Line | 307 S EVERGREEN AVE
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City | WOODBURY
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State | NJ
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Zip | 08096-2739
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Country | US
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Telephone | 856-686-4304
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Fax | 865-560-7078
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Authorized Official
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Title or Position | CFO
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Name | STEPHEN MURTAUGH
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Credential |
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Telephone | 856-686-4304
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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