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General NPI Number Information
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NPI Number | 1912453150
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Entity Type | Individual
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Provider Name | MAHER MATAR M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/28/2016
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Last Update Date | 08/28/2016
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Provider Practice Location Address
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Address Line | MUSC DEPARTMENT OF SURGERY-TRAUMA 96 JONATHAN LUCAS ST STE 420 CSB MSC 613
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City | CHARLESTON
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State | SC
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Zip | 29425
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Country | US
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Telephone | 843-792-3373
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Fax |
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Provider Business Mailing Address
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Address Line | 300 SEAPORT LN APT. 1309
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City | MOUNT PLEASANT
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State | SC
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Zip | 29464-2997
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Country | US
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Telephone | 843-557-7910
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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 | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | LL40065
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License Number State | SC
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