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General NPI Number Information
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NPI Number | 1417401944
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Entity Type | Individual
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Provider Name | MATTHEW NALAMLIENG DPM
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Gender | Male
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Dates
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Enumeration Date | 08/13/2016
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Last Update Date | 02/15/2024
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Provider Practice Location Address
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Address Line | 1107 14TH AVE SE STE 300
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City | DECATUR
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State | AL
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Zip | 35601-3368
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Country | US
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Telephone | 256-350-0362
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Fax |
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Provider Business Mailing Address
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Address Line | 1107 14TH AVE SE STE 300
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City | DECATUR
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State | AL
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Zip | 35601-3368
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Country | US
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Telephone | 256-350-0362
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | EL6682
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 387
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | 387
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License Number State | AL
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