Individual
ANIL ABRAHAM MATHEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13055 W MCDOWELL RD, AVONDALE, AZ 85392-6449
(882) 220-6432
(574) 335-0779
Mailing address
901 MCCLINTOCK DR STE 202, BURR RIDGE, IL 60527-0872
(630) 655-6748
(574) 335-0741
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
238788
NY
207RI0200X
Infectious Disease Physician
Primary
01076796A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201359350
—
IN
Enumeration date
04/20/2007
Last updated
09/18/2020
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