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General NPI Number Information
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NPI Number | 1568510568
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Entity Type | Organization
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Legal Business Name | UNDERWOOD-MEMORIAL HOSPITAL
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 04/22/2008
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Provider Practice Location Address
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Address Line | 1 W BROAD ST
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City | PAULSBORO
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State | NJ
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Zip | 08066-1527
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Country | US
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Telephone | 856-423-0033
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Fax | 856-423-4444
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Provider Business Mailing Address
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Address Line | 1120 DELSEA DR N
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City | GLASSBORO
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State | NJ
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Zip | 08028-1444
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Country | US
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Telephone | 856-423-0033
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Fax | 856-423-4444
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Authorized Official
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Title or Position | DIRECTOR OOF PRACTICE MANAGEMENT
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Name | MR. EDWARD SHIELDS
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Credential |
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Telephone | 856-845-0100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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