Individual
SUSAN MATHEWS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M D
Contact information
Practice address
275 E 200 S, SALT LAKE CITY, UT 84111-2002
(801) 428-2270
(801) 487-8197
Mailing address
PO BOX 100, GOBLES, MI 49055-0100
(269) 628-2339
Taxonomy
Speciality
Code
Description
License number
State
207QA0000X
Adolescent Medicine (Family Medicine) Physician
Primary
A52704
CA
Other
Enumeration date
04/26/2007
Last updated
07/08/2007
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