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General NPI Number Information
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NPI Number | 1770508459
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Entity Type | Organization
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Legal Business Name | CENTER FOR UROLOGIC CARE
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 502 CENTENNIAL BLVD STE 2
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City | VOORHEES
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State | NJ
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Zip | 08043
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Country | US
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Telephone | 856-751-7772
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Fax | 856-751-5328
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Provider Business Mailing Address
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Address Line | 502 CENTENNIAL BLVD STE 2
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City | VOORHEES
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State | NJ
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Zip | 08043
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Country | US
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Telephone | 856-751-7772
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Fax | 856-751-5328
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Authorized Official
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Title or Position | PHYSICIAN PARTNER
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Name | KARL H EBERT
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Credential | MD
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Telephone | 856-751-7772
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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