Provider Demographics
NPI:1881937381
Name:INFECTIOUS DISEASE PHYSICIANS,PA
Entity type:Organization
Organization Name:INFECTIOUS DISEASE PHYSICIANS,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:S
Authorized Official - Last Name:TOPIEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-866-7466
Mailing Address - Street 1:1001 BRIGGS RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-4100
Mailing Address - Country:US
Mailing Address - Phone:856-866-7466
Mailing Address - Fax:856-866-9088
Practice Address - Street 1:200 ROUTE 73
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-9611
Practice Address - Country:US
Practice Address - Phone:856-866-7466
Practice Address - Fax:856-866-9088
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:207R10200X
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-04-03
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09219700207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5100101Medicaid