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General NPI Number Information
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NPI Number | 1235303314
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Entity Type | Organization
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Legal Business Name | MATTHEW M. MONDI, P.C.
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Dates
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Enumeration Date | 04/18/2008
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Last Update Date | 04/18/2008
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Provider Practice Location Address
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Address Line | 1430 HARPER ST BUILDING B
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City | AUGUSTA
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State | GA
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Zip | 30901-0617
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Country | US
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Telephone | 706-724-5451
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Fax |
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Provider Business Mailing Address
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Address Line | 1430 HARPER ST BUILDING B
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City | AUGUSTA
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State | GA
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Zip | 30901-0617
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Country | US
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Telephone | 706-724-5451
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | DR. MATTHEW M MONDI
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Credential | M.D.
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Telephone | 706-724-5451
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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