MEDICARE: JULIA A MATTSON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	D0063050	MD

General Provider Information

NPI Number	:	1285603241
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIA A MATTSON M.D.

Provider Business Mailing Address
First Line	:	1602 ANGLESIDE RD
Second Line	:
City	:	FALLSTON
State	:	MD
Zip	:	21047-1744
Country	:	US
Telephone Number	:	410-652-8310
Fax Number	:

Provider Business Practice Location Address
First Line	:	1602 ANGLESIDE RD
Second Line	:
City	:	FALLSTON
State	:	MD
Zip	:	21047-1744
Country	:	US
Telephone Number	:	410-652-8310
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	01/18/2013

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