Active NPIIndividual provider

Dr. Jack Dwosh, MD

Urology in Mt. Laurel, New Jersey

NPI Number1033180724
Practice location
15000 Midlantic Drive, Suite 100, Mt. Laurel, NJ 08054
Fax
856-252-1100
Last updated
June 23, 2021

Jack Dwosh is an Urology based in Mt. Laurel, NJ. Jack Dwosh practices in Mt. Laurel, NJ and has the professional credentials of MD. The NPI Number for Jack Dwosh is 1033180724 and holds a License No. MD064953L (PA). The current practice location address for Jack Dwosh is 15000 Midlantic Drive, Suite 100, Mt. Laurel, NJ 08054 and can be reached out via phone at 856-252-1000 and via fax at 856-252-1100.

Provider Profile Details

NPI Number
1033180724
Provider Name
Jack Dwosh
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
15000 Midlantic Drive, Suite 100, Mt. Laurel, NJ 08054
Phone Number
856-252-1000
Fax Number
856-252-1100
Primary Taxonomy
Urology · 208800000X
Sole Proprietor
No
Provider Enumeration Date
January 30, 2006
Last Update Date
June 23, 2021
Certification Date
June 23, 2021
NPI Status
Active

Provider Business Practice Location Address Details

Address
15000 Midlantic Drive
Suite 100
Mt. Laurel, NJ 08054
Zip
08054
Phone Number
856-252-1000
Fax Number
856-252-1100
Mt. Laurel, NJ 08054Get directions →

Provider Business Mailing Address Details

Address
15000 Midlantic Dr
Suite 100
Mount Laurel, NJ 08054-1573
City
Mount Laurel
State
NJ
Zip
08054-1573
Phone Number
856-252-1000
Fax Number
856-252-1100

License Information

License Number (1)
MD064953L
License State (1)
PA
Taxonomy (1)
Urology · 208800000X
License Number (2)
25MA04771800
License State (2)
NJ
Taxonomy (2)
Urology · 208800000X · Primary

Legacy Identifiers

IdentifierTypeStateIssuer
No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider.

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Frequently Asked Questions

What is the NPI number of Dr. Jack Dwosh, MD?

The NPI number of Dr. Jack Dwosh, MD is 1033180724. It was assigned on January 30, 2006 and is currently active in the NPPES registry.

What is the specialty of Dr. Jack Dwosh, MD?

Dr. Jack Dwosh, MD is registered under the primary taxonomy Urology (code 208800000X), licensed in PA under license number MD064953L.

Where does Dr. Jack Dwosh, MD practice?

The practice location is 15000 Midlantic Drive, Suite 100, Mt. Laurel, NJ 08054. The office can be reached at 856-252-1000 (phone) or 856-252-1100 (fax).

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.

How do I verify this NPI record?

This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1033180724 directly on the NPPES registry website.

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