Individual
MARK WARREN MATTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
225 HOSPITAL DRIVE, GALAX, VA 24333-2228
(276) 236-6906
(276) 236-7179
Mailing address
PO BOX 1337, GALAX, VA 24333-1337
(276) 236-3210
(276) 236-8780
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0101030930
VA
208600000X
Surgery Physician
22944
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007335288
—
VA
Enumeration date
09/11/2006
Last updated
02/11/2015
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