Healthcare Provider Details
I. General information
NPI: 1962693432
Provider Name (Legal Business Name): MATTHEW JAMES GETTINGS D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/08/2007
Last Update Date: 01/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
73 N MAPLE AVE SUIRE B
MARLTON NJ
08053-1782
US
IV. Provider business mailing address
73 N MAPLE AVE SUIRE B
MARLTON NJ
08053-1782
US
V. Phone/Fax
- Phone: 844-542-2273
- Fax: 856-596-4043
- Phone: 844-542-2273
- Fax: 856-596-4043
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 25MB08643700 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: