Individual
MATTHEW JOSEPH VENGALIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1364 CLIFTON RD NE, ATLANTA, GA 30322-1059
(404) 778-3900
Mailing address
3621 S STATE ST, ANN ARBOR, MI 48108-1633
(734) 647-5299
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
036168543
IL
207L00000X
Anesthesiology Physician
Primary
111600
GA
207L00000X
Anesthesiology Physician
4301506463
MI
Other
Enumeration date
04/15/2018
Last updated
05/01/2026
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