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General NPI Number Information
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NPI Number | 1861468449
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Entity Type | Individual
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Provider Name | SALIM B MATHEW MD,MBA
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Gender | Male
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Dates
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Enumeration Date | 02/24/2006
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 650 PETER JEFFERSON PKWY STE 100
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22911
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Country | US
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Telephone | 434-293-4072
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Fax | 434-293-4265
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Provider Business Mailing Address
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Address Line | 650 PETER JEFFERSON PKWY STE 100
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22911-8844
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Country | US
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Telephone | 434-293-4072
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Fax | 434-293-4265
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 21765
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 1012622281
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License Number State | VA
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