Paul R Kouyoumdji, MD | |
4 By Pass Rd, Suite 101, Salem, NJ 08079-2053 | |
(856) 935-3582 | |
(856) 935-4382 |
Full Name | Paul R Kouyoumdji |
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Gender | Male |
Speciality | Pediatrics |
Location | 4 By Pass Rd, Salem, New Jersey |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1124027172 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | MA64453 (New Jersey) | Primary |
Entity Name | Inspira Health Network Medical Group Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1922177856 PECOS PAC ID: 4880797570 Enrollment ID: O20070319000280 |
Entity Name | Salem Physician Practices Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1245705128 PECOS PAC ID: 3476892050 Enrollment ID: O20190226000892 |
Mailing Address | Practice Location Address |
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Paul R Kouyoumdji, MD Po Box 504290, Saint Louis, MO 63150-0001 Ph: (856) 935-3582 | Paul R Kouyoumdji, MD 4 By Pass Rd, Suite 101, Salem, NJ 08079-2053 Ph: (856) 935-3582 |
Dr. Barry Mitchell Berman, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 4 By Pass Rd, Suite 101, Salem, NJ 08079 Phone: 856-935-3582 Fax: 856-935-4382 | |
Rebecca Mclane, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 238 E Broadway, Salem, NJ 08079 Phone: 856-935-7711 Fax: 856-935-9123 |