Individual
SEENAMMA MATHEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
9500 EUCLID AVE # P78-009, CLEVELAND, OH 44195
(216) 618-2316
Mailing address
225 CYPRESS RIDGE RD, TIFTON, GA 31794-1679
(229) 520-9387
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
022647
OH
363LA2100X
Acute Care Nurse Practitioner
Primary
RN196816
GA
Other
Enumeration date
02/06/2018
Last updated
06/20/2018
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