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General NPI Number Information
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NPI Number | 1134148588
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Entity Type | Individual
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Provider Name | DAVID J MATHISON M.D., M.B.A.
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Gender | Male
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 12/30/2013
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Provider Practice Location Address
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Address Line | 111 MICHIGAN AVE NW DIVISION OF EMERGENCY MEDICINE
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City | WASHINGTON
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State | DC
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Zip | 20010-2916
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Country | US
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Telephone | 202-476-4177
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Fax |
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Provider Business Mailing Address
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Address Line | 10101 EDWARD AVE
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City | BETHESDA
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State | MD
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Zip | 20814-2115
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Country | US
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Telephone | 301-742-7998
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 036-114606
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 2080P0204X
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Taxonomy Name | Pediatric Emergency Medicine (Pediatrics) Physician
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License Number | MD036676
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License Number State | DC
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Taxonomy #3
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Taxonomy Code | 2080P0204X
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Taxonomy Name | Pediatric Emergency Medicine (Pediatrics) Physician
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License Number | D0067848
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License Number State | MD
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