Individual
DR. BRIAN M MATHIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
5890 MAYFAIR RD, CANTON, OH 44720-1547
(330) 305-2200
(330) 305-2210
Mailing address
5890 MAYFAIR RD, CANTON, OH 44720-1547
(330) 305-2200
(330) 305-2210
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4213
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000203490
ANTHEM
—
01
—
001301628
KEYSTONE HEALTH/HIGHMARK
—
05
—
0844779
—
OH
01
—
1404675
UNITED HEALTH CARE
—
01
—
4384872
AETNA
OH
Enumeration date
06/20/2006
Last updated
07/08/2007
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