Individual
JONATHAN PUTHENVEETIL MATHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2310 ERWIN ROAD, DURHAM, NC 27710-1003
(919) 684-8111
Mailing address
BOX 3094 DUMC, DUKE UNIVERSITY MEDICAL CENTER, DURHAM, NC 27710-0001
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
2014016502
MO
207LP3000X
Pediatric Anesthesiology Physician
Primary
239680
NC
Other
Enumeration date
06/20/2014
Last updated
08/20/2018
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