Individual
MATTHEW D CARPENTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AAC
Contact information
Practice address
677 CHURCH ST NE, MARIETTA, GA 30060-1101
(770) 794-0477
(770) 794-3108
Mailing address
531 ROSELANE ST NW, SUITE 830, MARIETTA, GA 30060-6913
(770) 794-0477
(770) 794-3108
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
004372
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
904409222A
—
GA
05
—
904409222B
—
GA
Enumeration date
05/24/2006
Last updated
08/27/2019
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