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NPI Code Detail

MEDICARE: ROBERT G MATHENY MD

MEDICARE: ROBERT G MATHENY MD
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
1208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery) Physician046990GA

General Provider Information

NPI Number : 1336167535
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT G MATHENY MD
Provider Business Mailing Address
First Line : 5671 PEACHTREE DUNWOODY RD NE STE 550
Second Line :
City : ATLANTA
State : GA
Zip : 30342-5013
Country : US
Telephone Number : 404-252-9063
Fax Number : 404-252-0873
Provider Business Practice Location Address
First Line : 5671 PEACHTREE DUNWOODY RD NE STE 550
Second Line :
City : ATLANTA
State : GA
Zip : 30342-5013
Country : US
Telephone Number : 404-252-9063
Fax Number : 404-252-0873
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2006
Last Update Date : 07/08/2007

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