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Individual

DR. MATTHEW DANIEL POWELLSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1310 BRAMPTON AVE, STATESBORO, GA 30458-0851
(912) 486-1873
(912) 486-2394
Mailing address
1449 BRAMPTON AVE, STATESBORO, GA 30458-0854
(912) 871-2900
(912) 871-3901

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
066402
GA
208000000X
Pediatrics Physician
066402
GA

Other

Enumeration date
06/25/2007
Last updated
08/26/2014
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