Sicklerville Internal Medicine Associates Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MA61324 Issued in NJ

Legal business name

SICKLERVILLE INTERNAL MEDICINE ASSOCIATES INC

Practice address

485 Williamstown Rd
Sicklerville, NJ 08081-1777

Phone

(856) 237-8100

Fax

(856) 237-8142

NPI assigned

Jul 29, 2006

Last updated

Apr 29, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Maynard Holgado, D.O.NPI 1679526396

Title

Managing Partner

Phone

(856) 237-8160

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• S.I.M.A. Other name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Maynard Holgado, MD

  • Internal Medicine Physician
  • Sicklerville, NJ
  • NPI 1679526396
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209427200000",
    "number": "1912911207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "485 WILLIAMSTOWN RD",
            "city": "SICKLERVILLE",
            "state": "NJ",
            "postal_code": "080811777",
            "telephone_number": "856-237-8100",
            "fax_number": "856-237-8142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "485 WILLIAMSTOWN RD",
            "city": "SICKLERVILLE",
            "state": "NJ",
            "postal_code": "080811777",
            "telephone_number": "856-237-8100",
            "fax_number": "856-237-8142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SICKLERVILLE INTERNAL MEDICINE ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-29",
        "last_updated": "2008-04-29",
        "status": "A",
        "authorized_official_last_name": "HOLGADO",
        "authorized_official_first_name": "MAYNARD",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "856-237-8160",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA61324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3279600",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "S.I.M.A.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Amy Sheridan
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• Sicklerville Chiropractic
• Sicklerville Internal Medicine
• Sicklerville Shoprite, Inc
• Sicklerville Smiles
• Cheryl Silvano
• Derek Xavier Simmons
• Shari K. Simon, D.O.

• Internal Medicine Physician in Sicklerville, NJ
• Providers in Sicklerville, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.