Individual
DR. STEPHEN CARL MATHAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD MHS
Contact information
Practice address
4940 EASTERN AVE, BALTIMORE, MD 21224-2735
(410) 550-5864
Mailing address
PO BOX 64264, BALTIMORE, MD 21264-4264
(410) 550-5864
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
D0060811
MD
207RP1001X
Pulmonary Disease Physician
Primary
D60811
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
405712100
—
MD
Enumeration date
08/16/2006
Last updated
02/12/2013
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