Provider Demographics
NPI:1700825783
Name:KNOD, GEORGE A (DO)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:A
Last Name:KNOD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:PO BOX 8505
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-0505
Mailing Address - Country:US
Mailing Address - Phone:856-755-1616
Mailing Address - Fax:856-755-0098
Practice Address - Street 1:1600 HADDON AVE
Practice Address - Street 2:ROOM 122
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-3101
Practice Address - Country:US
Practice Address - Phone:856-757-3879
Practice Address - Fax:856-757-3760
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB04884600208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1067121OtherHORIZON NJ HEALTH
NJF01769OtherHEALTH NET
1065337001OtherCIGNA
16047OtherMULTIPLAN
JS273OtherOXFORD
NJ2138506Medicaid
30009799OtherKEYSTONE MERCY
133302OtherINDEPENDENCE BCBS
NJ0082517000OtherAMERIHEALTH / KEYSTONE
824323OtherCHN
1065337OtherCCN
NJ55681OtherAETNA
NJ133302AHSMedicare ID - Type Unspecified