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General NPI Number Information
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NPI Number | 1558850214
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Entity Type | Organization
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Legal Business Name | INLET MEDICAL ASSOCIATES, INC
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Dates
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Enumeration Date | 05/08/2018
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Last Update Date | 05/08/2018
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Provider Practice Location Address
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Address Line | 16 S RHODE ISLAND AVE
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City | ATLANTIC CITY
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State | NJ
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Zip | 08401-7759
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Country | US
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Telephone | 609-559-0070
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Fax |
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Provider Business Mailing Address
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Address Line | 199 NEW RD STE 61-398
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City | LINWOOD
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State | NJ
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Zip | 08221-2025
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PETER KUPONIYI
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Credential |
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Telephone | 609-559-0070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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