MEDICARE: HUSSEIN KILIDDAR MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MD-417448	PA
2	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	MD417448	PA
3	207RP1001X	Pulmonary Disease Physician	MD417448	PA
4	207RS0012X	Sleep Medicine (Internal Medicine) Physician	MD-417448	PA
5	207RP1001X	Pulmonary Disease Physician	25MA07901200	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023122306
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HUSSEIN KILIDDAR MD

Provider Business Mailing Address
First Line	:	1 FEDERAL ST # 200
Second Line	:
City	:	CAMDEN
State	:	NJ
Zip	:	08103-1088
Country	:	US
Telephone Number	:	856-356-4924
Fax Number	:

Provider Business Practice Location Address
First Line	:	66 EAST AVE
Second Line	:
City	:	WOODSTOWN
State	:	NJ
Zip	:	08098-1417
Country	:	US
Telephone Number	:	856-935-6700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	11/09/2020

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Directions to “ HUSSEIN KILIDDAR MD” Practice Location

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