Individual
MIA M MATHEWSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
575 PROFESSIONAL DR, STE 165, LAWRENCEVILLE, GA 30046-3333
(770) 277-3056
(855) 204-5244
Mailing address
PO BOX 551420, FORT LAUDERDALE, FL 33355-1420
(800) 243-3839
(855) 851-4405
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
077658
GA
207LP3000X
Pediatric Anesthesiology Physician
N4578
TX
Other
Enumeration date
05/03/2007
Last updated
04/27/2017
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