Provider Demographics
NPI:1205910676
Name:CUMBERLAND ORTHOPEDIC PROFESSIONAL ASSOCIATION
Entity type:Organization
Organization Name:CUMBERLAND ORTHOPEDIC PROFESSIONAL ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WINFIELD
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-696-2010
Mailing Address - Street 1:2848 S DELSEA DR
Mailing Address - Street 2:BLDG 1
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-7042
Mailing Address - Country:US
Mailing Address - Phone:856-696-2010
Mailing Address - Fax:856-696-3689
Practice Address - Street 1:2848 S DELSEA DR
Practice Address - Street 2:BLDG 1
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-7042
Practice Address - Country:US
Practice Address - Phone:856-696-2010
Practice Address - Fax:856-696-3689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Multi-Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2820706Medicaid
NJ542662Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
NJ542662Medicare PIN
NJ2820706Medicaid