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General NPI Number Information
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NPI Number | 1881732667
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Entity Type | Organization
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Legal Business Name | STEVEN POTTER, MD LLC
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Dates
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Enumeration Date | 02/02/2007
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Last Update Date | 09/26/2011
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Provider Practice Location Address
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Address Line | 287 BOULEVARD SUITE #1
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City | POMPTON PLAINS
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State | NJ
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Zip | 07444-1726
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Country | US
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Telephone | 973-839-7400
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Fax | 973-831-4911
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Provider Business Mailing Address
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Address Line | PO BOX 367
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City | POMPTON PLAINS
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State | NJ
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Zip | 07444-0367
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Country | US
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Telephone | 973-839-7400
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Fax | 973-831-4911
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STEVEN DARREN POTTER
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Credential | M.D.
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Telephone | 973-839-7400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 25MA056450
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License Number State | NJ
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