Individual
MARIAMMA SUNNY MATHEW
Active
Individual
MARIAMMA SUNNY MATHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
645286
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
187658302
—
TX
01
—
8Y3243
BLUE CROSS BLUE SHIELD
TX
Enumeration date
11/12/2007
Last updated
11/22/2008
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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