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General NPI Number Information
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NPI Number | 1356835664
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Entity Type | Individual
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Provider Name | MATTHEW JAMES VOSTERS MD
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Gender | Male
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Dates
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Enumeration Date | 06/20/2018
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Last Update Date | 08/07/2023
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Provider Practice Location Address
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Address Line | 5445 MERIDIAN MARK RD STE 250
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City | ATLANTA
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State | GA
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Zip | 30342-4767
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Country | US
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Telephone | 404-255-1933
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Fax |
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Provider Business Mailing Address
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Address Line | 5445 MERIDIAN MARK RD STE 250
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City | ATLANTA
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State | GA
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Zip | 30342-4767
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Country | US
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Telephone | 404-255-1933
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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 | 2080S0010X
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Taxonomy Name | Pediatric Sports Medicine Physician
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License Number | 96557
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 4301115577
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 2080S0010X
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Taxonomy Name | Pediatric Sports Medicine Physician
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License Number | 35.144769
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License Number State | OH
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