Individual
MAHENDRA K MATTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10496 MONTGOMERY RD, SUITE 204, CINCINNATI, OH 45242-5223
(513) 793-9835
(513) 793-9837
Mailing address
10496 MONTGOMERY RD, SUITE 204, CINCINNATI, OH 45242-5223
(513) 793-9835
(513) 793-9837
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
35-04263
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000009386
ANTHEM PROVIDER
OH
05
—
0384221
—
OH
01
—
1720085
UNITED HEALTHCARE
OH
01
—
310983038
CIGNA PROVIDER
OH
Enumeration date
03/17/2006
Last updated
01/07/2015
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