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Contact Information

JACK DWOSH, MD
15000 MIDLANTIC DRIVE
SUITE 100
MOUNT LAUREL, NJ08054
 Phone: 856-252-1000
 Fax: 856-252-1100
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Urology

208800000X 34 Physician/Urology
Indicates primary specialty

NPI Profile & details for JACK DWOSH · (Male)

NPI Number 1033180724
Status Active
Credentials MD
Entity Individual
Enumeration date 01/30/2006
Last updated 06/23/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • NJ License # 25MA04771800
  • PA License # MD064953L
  • Other 0055472 AETNA
  • Other 0073781000 AMERIHEALTH
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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