Individual
DR. GOSSIE COLETTE HEATH MATHIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
130 PLAZA CIR, SANTEE, SC 29142-9630
(803) 854-3940
(803) 854-3945
Mailing address
PO BOX 277, SANTEE, SC 29142-0277
(803) 854-3940
(803) 854-3945
Taxonomy
Speciality
Code
Description
License number
State
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
Primary
13454
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GPO261
—
SC
Enumeration date
04/03/2007
Last updated
02/18/2015
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