Provider Demographics
NPI:1841335262
Name:UDERMAN, HOWARD D (MD)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:D
Last Name:UDERMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1771 MADISON AVE
Mailing Address - Street 2:CHEMED
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-1251
Mailing Address - Country:US
Mailing Address - Phone:732-664-2144
Mailing Address - Fax:732-364-3559
Practice Address - Street 1:1771 MADISON AVE
Practice Address - Street 2:CHEMED
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-1251
Practice Address - Country:US
Practice Address - Phone:732-364-2144
Practice Address - Fax:732-364-3559
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2013-05-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA05551300207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
B40311Medicare UPIN