Individual
DR. MATTHEW O BURRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
759 OLD NORCROSS RD, LAWRENCEVILLE, GA 30046-4317
(404) 300-2379
(404) 300-2379
Mailing address
759 OLD NORCROSS RD, LAWRENCEVILLE, GA 30046-4317
(404) 300-2379
(404) 300-2379
Taxonomy
Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
Primary
017998
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000086589F
—
GA
05
—
000086589G
—
GA
05
—
000086589H
—
GA
05
—
00086589B
—
GA
01
—
025915
BCBS
GA
01
—
0702361
UHC
GA
Enumeration date
02/24/2006
Last updated
02/01/2017
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