Provider Demographics
NPI:1265538904
Name:SIROVER, WILLIAM (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:SIROVER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 FEDERAL ST # 200
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1088
Mailing Address - Country:US
Mailing Address - Phone:856-356-4924
Mailing Address - Fax:
Practice Address - Street 1:3 COOPER PLZ
Practice Address - Street 2:SUITE 215
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1438
Practice Address - Country:US
Practice Address - Phone:856-757-7844
Practice Address - Fax:856-757-7778
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07943200207RN0300X, 207RN0300X
NJMA79432207R00000X, 207RN0300X
PAMD419048207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
3972119OtherAETNA
41917OtherUNIVERSITY HEALTHPLAN
7574339OtherCIGNA
P3708020OtherOXFORD
P3708020OtherOXFORD HEALTH CARE
2566688OtherUNITED HEALTHCARE
010007620OtherAMERICHOICE
60020029OtherHORIZON NJ HEALTH
NJ0078751Medicaid
3K6113OtherHEALTHNET
2626802000OtherAMERIHEALTH, KEYSTONE, IBC
60020029OtherHORIZON NJ HEALTH
P3708020OtherOXFORD HEALTH CARE