Provider Demographics
NPI:1659563807
Name:NOGUEIRA, EMANUEL FLORIM (MD)
Entity Type:Individual
Prefix:DR
First Name:EMANUEL
Middle Name:FLORIM
Last Name:NOGUEIRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1021 PARK AVE
Mailing Address - Street 2:SUITE 100B
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951-1573
Mailing Address - Country:US
Mailing Address - Phone:215-538-4852
Mailing Address - Fax:215-529-4685
Practice Address - Street 1:1021 PARK AVE
Practice Address - Street 2:SUITE 100B
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951-1573
Practice Address - Country:US
Practice Address - Phone:215-538-4852
Practice Address - Fax:215-529-4685
Is Sole Proprietor?:No
Enumeration Date:2007-08-13
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD13576208600000X
PAMD444096208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102661261Medicaid
PA233134Medicare PIN