Provider Demographics
NPI:1174564793
Name:MCWHORTER, JOHN E (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:E
Last Name:MCWHORTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 UNION AVE
Mailing Address - Street 2:2D
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-3002
Mailing Address - Country:US
Mailing Address - Phone:908-722-5380
Mailing Address - Fax:908-685-7501
Practice Address - Street 1:201 UNION AVE
Practice Address - Street 2:2D
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-3002
Practice Address - Country:US
Practice Address - Phone:908-722-5380
Practice Address - Fax:908-685-7501
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA029905207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ33889OtherAETNA
NJ0996898003OtherCIGNA
NJ33889OtherAETNA
460623Medicare ID - Type Unspecified