Individual
HERBERT REID MATTISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1633 N CAPITOL AVE., SUITE 750, INDIANAPOLIS, IN 46202-1270
(317) 962-0953
(317) 962-2455
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01039266A
IN
207RI0200X
Infectious Disease Physician
Primary
01039266A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100102960
—
IN
Enumeration date
06/07/2006
Last updated
07/20/2022
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