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Individual

DR. MANOJ MATHEW

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3811 E BELL RD STE 107, PHOENIX, AZ 85032-2158
(602) 340-1689
(602) 340-1853
Mailing address
5151 E BROADWAY RD STE 107, MESA, AZ 85206-1346
(480) 290-7000
(602) 254-6840

Taxonomy

Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
33087
AZ
207RP1001X
Pulmonary Disease Physician
Primary
33087
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
33087
AZ MD LIC
AZ
01
874554
UPIN
AZ
05
874554
AZ
Enumeration date
03/29/2007
Last updated
12/11/2020
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