Provider Demographics
NPI:1689676454
Name:WINTER, HOWARD (MD)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:
Last Name:WINTER
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 1:301 LIPPINCOTT DR
Mailing Address - Street 2:STE 120
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4197
Mailing Address - Country:US
Mailing Address - Phone:856-355-0335
Mailing Address - Fax:856-355-0354
Practice Address - Street 1:502 CENTENNIAL BLVD
Practice Address - Street 2:SUITE 7
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-9544
Practice Address - Country:US
Practice Address - Phone:856-596-7440
Practice Address - Fax:856-596-6723
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA03529700208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1087207Medicaid
NJ400940Medicare ID - Type Unspecified
NJ1087207Medicaid