Individual
AYAZ MATIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
701 OSTRUM ST, SUITE 201, FOUNTAIN HILL, PA 18015-1155
(484) 526-7575
(484) 526-7576
Mailing address
PO BOX 95000-2433, PHILADELPHIA, PA 19195-2433
(484) 526-7575
(484) 526-7576
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD432229
PA
207RG0100X
Gastroenterology Physician
262338
NY
207RG0100X
Gastroenterology Physician
Primary
MD432229
PA
208M00000X
Hospitalist Physician
MD432229
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102003837
—
PA
Enumeration date
08/05/2007
Last updated
08/20/2012
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