Provider Demographics
NPI:1376631028
Name:KERNER, SHELDON P (DO)
Entity Type:Individual
Prefix:
First Name:SHELDON
Middle Name:P
Last Name:KERNER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 COOPER PLZ
Mailing Address - Street 2:SUITE 502
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1438
Mailing Address - Country:US
Mailing Address - Phone:856-968-7433
Mailing Address - Fax:
Practice Address - Street 1:1 COOPER PLZ
Practice Address - Street 2:COOPER UNIVERSITY RADIOLOGY
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1461
Practice Address - Country:US
Practice Address - Phone:856-342-2382
Practice Address - Fax:856-365-0472
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB250212085B0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ01000574300OtherAMERICHOICE
NJ1027495OtherCIGNA
NJP3737605OtherOXFORD
NJ067655OtherAMERIHEALTH PPO/PA BS
NJ2034701Medicaid
NJP00088082OtherRR MEDICARE
NJ067655OtherPA PB HIGHMARK
NJ60003096OtherHORIZON NJ HEALTH
NJ3391419OtherAETNA
NJ0076010000OtherAMERIHEALTH/KEYSTONE/IBC
NJ1277464OtherUNITED HEALTHCARE
NJ067655 SF5Medicare PIN
NJ1027495OtherCIGNA