Individual
ALEYAMMA J MATHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D27716
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
397801000
—
MD
01
—
417596-01 & 02
BLUE CROSS/BLUE SHIELD
MD
01
—
6391
MEDICARE - PRIVATE PRACTICE
MD
Enumeration date
06/23/2006
Last updated
11/06/2013
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