Wyche-Bullock, Tara L.

Wyche-Bullock, Tara L. is an individual health care provider with primary practice located at 485 Williamstown Rd , Sicklerville NJ 08081-1777. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Wyche-Bullock, Tara L. can be contacted via phone (856) 237-8100.

Contact Information

Primary practice address
485 Williamstown Rd Sicklerville NJ 08081-1777
Phone: (856) 237-8100
Fax: (856) 237-8042
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 25MA07694800 New Jersey

Profile Details

NPI number 1720008931
LBN Legal business name Wyche-Bullock, Tara L.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2006
Last updated Jan 7th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720008931 NPPES
New Jersey Other 2030554 CIGNA
New Jersey Other 304846 CIGNA

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