Individual
PROF. MATTHEW WILLIAM KERVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
163 HOSPITAL DR, TOCCOA, GA 30577-6820
(706) 282-4266
Mailing address
563 SILVER SHOALS RD, SILVER SHOALS ROAD, EASTANOLLEE, GA 30538-3523
(706) 244-0390
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN134100
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
579195040B
—
GA
01
—
P00291614
RAILROAD MEDICARE
—
Enumeration date
10/26/2005
Last updated
05/08/2008
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