Provider Demographics
NPI:1225036866
Name:AUERBACH, DONALD (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:
Last Name:AUERBACH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 BERLIN RD
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-3526
Mailing Address - Country:US
Mailing Address - Phone:856-429-1800
Mailing Address - Fax:856-429-1081
Practice Address - Street 1:750 RT 73 SOUTH
Practice Address - Street 2:SUITE 401
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-4145
Practice Address - Country:US
Practice Address - Phone:856-375-1288
Practice Address - Fax:856-375-2325
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02298200207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3896501Medicaid
NJ3896501Medicaid
AU37208Medicare ID - Type Unspecified