Individual
MARK D. MATHASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
700 E BROAD ST, HAZLETON, PA 18201-6835
(570) 501-4193
Mailing address
307 S EVERGREEN AVE, WOODBURY, NJ 08096-2739
(856) 686-4300
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
25MB08065000
NJ
207P00000X
Emergency Medicine Physician
OS017050
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0108448
—
NJ
Enumeration date
07/18/2006
Last updated
05/11/2023
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