Provider Demographics
NPI:1972563740
Name:TULMAN, ALAN B (MD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:B
Last Name:TULMAN
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 1:406 LIPPINCOTT DRIVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4168
Mailing Address - Country:US
Mailing Address - Phone:856-983-1900
Mailing Address - Fax:856-983-1914
Practice Address - Street 1:406 LIPPINCOTT DRIVE
Practice Address - Street 2:SUITE E
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-4168
Practice Address - Country:US
Practice Address - Phone:856-983-1900
Practice Address - Fax:856-983-5110
Is Sole Proprietor?:No
Enumeration Date:2006-03-25
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ03565800207RG0100X
NJ25MA03565800207RG0100X
NJMA03565800207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0619108Medicaid
NJ619108Medicaid
NJ138150BL3Medicare PIN
C59811Medicare UPIN
138150BL3Medicare PIN
NJ138150A7RMedicare UPIN
NJ0619108Medicaid