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General NPI Number Information
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NPI Number | 1831615020
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Entity Type | Individual
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Provider Name | SABRINA MATHEW PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/18/2017
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Last Update Date | 08/18/2017
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Provider Practice Location Address
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Address Line | 1800 ORLEANS ST
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City | BALTIMORE
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State | MD
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Zip | 21287-0010
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Country | US
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Telephone | 301-979-1284
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Fax |
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Provider Business Mailing Address
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Address Line | 18921 PORTERFIELD WAY
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City | GERMANTOWN
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State | MD
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Zip | 20874-1880
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Country | US
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Telephone |
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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 | C0006543
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License Number State | MD
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