Individual
NICOLE MATHIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
720 WESTVIEW DR SW, MOREHOUSE SCHOOL OF MEDICINE/GME, ATLANTA, GA 30310-1458
(404) 756-1393
Mailing address
9264 N PLATT RD, MILAN, MI 48160-9538
(757) 342-2745
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/28/2017
Last updated
05/08/2018
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