Provider Demographics
NPI:1891852489
Name:MIDDLETON, JOHN R (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:R
Last Name:MIDDLETON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3 HOSPITAL PLZ
Mailing Address - Street 2:SUITE 208
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-3093
Mailing Address - Country:US
Mailing Address - Phone:732-360-2700
Mailing Address - Fax:732-360-2703
Practice Address - Street 1:3 HOSPITAL PLZ
Practice Address - Street 2:SUITE 208
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-3093
Practice Address - Country:US
Practice Address - Phone:732-360-2700
Practice Address - Fax:732-360-2703
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2010-05-26
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Provider Licenses
StateLicense IDTaxonomies
NJMA28183207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1777203Medicaid
NJD19249Medicare UPIN
NJ1777203Medicaid