Provider Demographics
NPI:1487653770
Name:NAMM, JOEL (MD)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:
Last Name:NAMM
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 1:3625 QUAKERBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-1207
Mailing Address - Country:US
Mailing Address - Phone:609-689-1600
Mailing Address - Fax:609-689-1200
Practice Address - Street 1:1255 WHITEHORSE MERCERVILLE RD
Practice Address - Street 2:SUITE 514
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-3800
Practice Address - Country:US
Practice Address - Phone:609-585-8800
Practice Address - Fax:609-585-1825
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA024566002085B0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA00842793Medicaid
NJ0707601Medicaid
NJ183354Medicare ID - Type Unspecified
NJ0707601Medicaid
PA695628Medicare ID - Type Unspecified