Individual
STEPHANY KHALIL MATTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
198 CHARLTON RD, STURBRIDGE, MA 01566-1571
(508) 347-7585
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
1017403
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110117231A
—
MA
Enumeration date
08/25/2015
Last updated
12/18/2024
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