Provider Demographics
NPI:1265452684
Name:SVIGALS, PAUL J (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:J
Last Name:SVIGALS
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 1:200 CENTURY PKWY
Mailing Address - Street 2:SUITE E
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-1150
Mailing Address - Country:US
Mailing Address - Phone:856-482-2800
Mailing Address - Fax:856-482-9399
Practice Address - Street 1:200 CENTURY PKWY
Practice Address - Street 2:SUITE E
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-1150
Practice Address - Country:US
Practice Address - Phone:856-482-2800
Practice Address - Fax:856-482-9399
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA073173002085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8181403Medicaid
D27800Medicare UPIN
NJ054951TNXMedicare ID - Type Unspecified