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NPI Code Detail

MEDICARE: MISS DONALD MILLS MATHESON M.D.

MEDICARE: MISS DONALD MILLS MATHESON 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
1207Q00000XFamily Medicine PhysicianG25745CA

General Provider Information

NPI Number : 1629060900
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS DONALD MILLS MATHESON M.D.
Provider Business Mailing Address
First Line : 1245 S MAIN ST
Second Line :
City : WILLITS
State : CA
Zip : 95490-4305
Country : US
Telephone Number : 707-459-6861
Fax Number : 707-459-3057
Provider Business Practice Location Address
First Line : 1245 S MAIN ST
Second Line :
City : WILLITS
State : CA
Zip : 95490-4305
Country : US
Telephone Number : 707-459-6861
Fax Number : 707-459-3057
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2005
Last Update Date : 07/08/2007

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Directions to “ MISS DONALD MILLS MATHESON M.D.” Practice Location

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