Healthcare Provider Details

I. General information

NPI: 1174966998
Provider Name (Legal Business Name): ERIN ABBOTT STREET MATEER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERIN ABBOTT STREET MD

II. Dates (important events)

Enumeration Date: 04/11/2013
Last Update Date: 06/02/2022
Certification Date: 06/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8172 CHAUCER DR
WEEKI WACHEE FL
34607-2204
US

IV. Provider business mailing address

34607 CRYSTAL SPRING RUN
WEEKI WACHEE FL
34607
US

V. Phone/Fax

Practice location:
  • Phone: 352-653-1101
  • Fax:
Mailing address:
  • Phone: 703-300-7481
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME130441
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: