| Main Street Family Medicine, Pa | |
|
111 Vine St Hammonton NJ 08037-1447 | |
| (609) 561-2518 | |
| Not Available |
| Full Name | Main Street Family Medicine, Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 111 Vine St, Hammonton, New Jersey |
| Authorized Official Name and Position | Walter D Crane (PHYSICIAN) |
| Authorized Official Contact | 6095612518 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Main Street Family Medicine, Pa 111 Vine St Hammonton NJ 08037-1447 Ph: (609) 561-2518 | Main Street Family Medicine, Pa 111 Vine St Hammonton NJ 08037-1447 Ph: (609) 561-2518 |
| NPI Number | 1467510008 |
|---|---|
| Provider Enumeration Date | 12/05/2006 |
| Last Update Date | 04/18/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467510008 | NPI | - | NPPES |
| 3411001 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MB42970 (New Jersey) | Primary |
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