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General NPI Number Information
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NPI Number | 1740217017
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Entity Type | Individual
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Provider Name | MATTHEW A DOVIE PA
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Gender | Male
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Dates
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Enumeration Date | 06/26/2006
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Last Update Date | 01/18/2012
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Provider Practice Location Address
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Address Line | 2335 LIMESTONE OVERLOOK
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City | GAINESVILLE
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State | GA
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Zip | 30501-7443
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Country | US
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Telephone | 770-297-0356
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Fax |
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Provider Business Mailing Address
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Address Line | 3525 PIEDMONT RD NE #7-601
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City | ATLANTA
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State | GA
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Zip | 30305-1578
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Country | US
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Telephone | 404-842-5425
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 003457
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License Number State | GA
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