Eric Robert Requa, D.O. Valid NPI

Individual provider · Sports Medicine (Family Medicine) Physician · Marlton, NJ

NPI

1164788501

Type

Individual (Type 1)

Primary specialty

Sports Medicine (Family Medicine) Physician (Family Medicine)

Specialty group

Allopathic & Osteopathic Physicians

Taxonomy code

207QS0010X

License number

25MB09913200 (NJ)

Sex

Male

Sole proprietor

No

Enumerated

2012-04-10

Last updated

2020-10-15