MEDICARE: MOHAMED SFAXI M.D.

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	2085R0202X	Diagnostic Radiology Physician	MD423505	PA
2	2085R0202X	Diagnostic Radiology Physician	25MA07808800	NJ

General Provider Information

NPI Number	:	1770569378
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOHAMED SFAXI M.D.

Provider Business Mailing Address
First Line	:	2201 CHAPEL AVE W
Second Line	:
City	:	CHERRY HILL
State	:	NJ
Zip	:	08002-2048
Country	:	US
Telephone Number	:	856-488-6500
Fax Number	:	856-922-5109

Provider Business Practice Location Address
First Line	:	2201 CHAPEL AVE W
Second Line	:
City	:	CHERRY HILL
State	:	NJ
Zip	:	08002-2048
Country	:	US
Telephone Number	:	856-488-6500
Fax Number	:	856-922-5109

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

Provider Enumeration Date	:	12/16/2005
Last Update Date	:	04/20/2018

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