Individual
MATTHEW M MONDI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
818 SAINT SEBASTIAN WAY STE 104, AUGUSTA, GA 30901-2652
(706) 434-0130
Mailing address
PO BOX 1705, AUGUSTA, GA 30903-1705
(706) 854-6008
(706) 774-7230
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
060940
GA
208600000X
Surgery Physician
2004-00150
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10409292
—
VA
01
—
1429K
BLUE CROSS
NC
01
—
190681
MEDCOST
NC
05
—
3810008155
—
WV
05
—
5905895
—
NC
01
—
7406921
AETNA
NC
01
—
808466
PARTNERS
NC
05
—
Q0015H
—
SC
Enumeration date
07/28/2006
Last updated
01/10/2023
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