Individual
PETER MATHERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
77 W FOREST AVE, FLAGSTAFF, AZ 86001-1479
(928) 635-7307
(928) 774-3844
Mailing address
PO BOX 749495, ATLANTA, GA 30374-9495
(855) 963-2100
(813) 321-1296
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
24332
AZ
207RX0202X
Medical Oncology Physician
Primary
24332
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
361311
—
AZ
Enumeration date
05/05/2006
Last updated
03/09/2026
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