MEDICARE: JOEL NAMM 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	2085B0100X	Body Imaging Physician	MA02456600	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487653770
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOEL NAMM MD

Provider Business Mailing Address
First Line	:	3625 QUAKERBRIDGE RD
Second Line	:
City	:	HAMILTON
State	:	NJ
Zip	:	08619-1207
Country	:	US
Telephone Number	:	609-689-1600
Fax Number	:	609-689-1200

Provider Business Practice Location Address
First Line	:	1255 WHITEHORSE MERCERVILLE RD
Second Line	:	SUITE 514
City	:	HAMILTON
State	:	NJ
Zip	:	08619-3800
Country	:	US
Telephone Number	:	609-585-8800
Fax Number	:	609-585-1825

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

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	07/08/2007

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