Individual
ALYSSA MARY MATHEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O
Contact information
Practice address
4920 CAMPBELL BLVD, NOTTINGHAM, MD 21236-5916
(410) 933-7600
Mailing address
632 HICKORY OVERLOOK DR, BEL AIR, MD 21014-1864
(732) 670-4590
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
H83040
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/16/2014
Last updated
09/12/2023
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