Individual
AKBAR GULAMMOHAMED MATADAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD FACS
Contact information
Practice address
41199 YAKEY LN, LOVETTSVILLE, VA 20180-2401
(412) 708-7240
Mailing address
380 SUMMIT AVE, STEUBENVILLE, OH 43952-2667
(740) 283-7597
(740) 283-7807
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
0101266792
VA
207Y00000X
Otolaryngology Physician
10680
WV
207Y00000X
Otolaryngology Physician
35 03 9470
OH
207Y00000X
Otolaryngology Physician
MD 017518E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000113358
ANTHEM
—
01
—
001705974
MOUNTAIN STATE BC BS
—
05
—
0295256
—
OH
01
—
0598454
MEDICARE
—
01
—
220876
CARELINK
—
01
—
35183
COVENTRY
—
01
—
P00695984
RR MEDICARE
OH
01
—
P01020743
RR MEDICARE
OH
Enumeration date
12/20/2005
Last updated
12/09/2019
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