Individual
DR. SMITHA RAJAN MATHEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-3957
(706) 721-8623
Mailing address
1120 15TH ST STE BI1056, AUGUSTA, GA 30912-0004
(706) 446-5941
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
081114
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/08/2011
Last updated
07/25/2018
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