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Individual

DR. VINITA MATHUR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
350 HOSPITAL DR, MACON, GA 31217-3838
(787) 654-8724
(475) 751-0455
Mailing address
350 HOSPITAL DR, MACON, GA 31217-3838
(787) 654-8724
(475) 751-0455

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
200500221
NC
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD0000043396
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
046JM
BCBS NC
NC
01
130I227776
MEDICARE PTAN
TN
01
3721566
GROUP PTAN
TN
05
5900266
NC
01
E4403-26290
MEDCOST
NC
Enumeration date
08/29/2005
Last updated
08/12/2025
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