Individual
MR. JATIN R MATTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C, MPAS
Contact information
Practice address
1450 MERCANTILE LN, SUITE 217, LARGO, MD 20774-5376
(301) 583-7770
(301) 583-9414
Mailing address
16831 HARBOUR TOWN DR, SILVER SPRING, MD 20905-4021
(301) 476-9226
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0002229
MD
363A00000X
Physician Assistant
PA30146
DC
Other
Enumeration date
06/09/2011
Last updated
06/09/2011
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