Individual
DR. ADAM REED MATTOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
909 FULTON ST SE, MINNEAPOLIS, MN 55455-4800
(612) 672-7422
Mailing address
7031 ANTLER WAY, APT. 3D, INDIANAPOLIS, IN 46254-5622
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
62408
MN
207R00000X
Internal Medicine Physician
11014342A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/17/2008
Last updated
10/05/2017
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