Healthcare Provider Details

I. General information

NPI: 1316687502
Provider Name (Legal Business Name): ISABELLA MATEU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2022
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5780 PEACHTREE DUNWOODY RD STE 295
SANDY SPRINGS GA
30342-1544
US

IV. Provider business mailing address

5780 PEACHTREE DUNWOODY RD STE 295
SANDY SPRINGS GA
30342-1544
US

V. Phone/Fax

Practice location:
  • Phone: 404-255-3633
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberLL87863
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number112192
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: