Individual
SUSAN P. MATHEW
Active
Individual
SUSAN P. MATHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
031212
CT
207R00000X
Internal Medicine Physician
031212
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010031212CT
ANTHEM
CT
01
—
060646704
TRI-CARE
—
05
—
1770675480
—
CT
05
—
4024972
—
CT
05
—
4041679
—
CT
Enumeration date
09/29/2006
Last updated
10/27/2010
Update your record
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