Individual
DR. MAMMEN M MATHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
243 WOODROW WILSON LANE, FISHERSVILLE, VA 22939
(540) 332-7082
Mailing address
243 WOODROW WILSON LANE, PO BOX 1500 BOX W-1, FISHERSVILLE, VA 22939
(540) 332-7082
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
0101037344
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006822851
—
VA
Enumeration date
01/25/2006
Last updated
11/03/2015
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