MEDICARE: DR. R MATTHEW KAMINS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	039832	GA

General Provider Information

NPI Number	:	1285976928
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. R MATTHEW KAMINS M.D.

Provider Business Mailing Address
First Line	:	2480 BRIARCLIFF RD NE
Second Line	:	SUITE 6-233
City	:	ATLANTA
State	:	GA
Zip	:	30329-3034
Country	:	US
Telephone Number	:	404-499-1444
Fax Number	:	404-499-1444

Provider Business Practice Location Address
First Line	:	2480 BRIARCLIFF RD NE
Second Line	:	SUITE 6-233
City	:	ATLANTA
State	:	GA
Zip	:	30329-3034
Country	:	US
Telephone Number	:	404-499-1444
Fax Number	:	404-499-1444

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2013
Last Update Date	:	10/15/2016

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