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NPI Code Detail

MEDICARE: SOBHAN MATHEW MD

MEDICARE: SOBHAN MATHEW 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
1207R00000XInternal Medicine PhysicianD47604MD

General Provider Information

NPI Number : 1477098523
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOBHAN MATHEW MD
Provider Business Mailing Address
First Line : PO BOX 157
Second Line :
City : ASHTON
State : MD
Zip : 20861-0157
Country : US
Telephone Number : 301-570-9700
Fax Number : 301-260-2838
Provider Business Practice Location Address
First Line : 3048 MITCHELLVILLE RD
Second Line :
City : BOWIE
State : MD
Zip : 20716-1388
Country : US
Telephone Number : 301-218-1456
Fax Number : 301-218-1462
Authorized Official
Title or Position : OWNER
Name : DR. SOBHAN MATHEW
Credential : MD
Telephone Number : 301-218-1456
Provider Enumeration Date : 12/28/2016
Last Update Date : 12/28/2016

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Directions to “SOBHAN MATHEW MD ” Practice Location

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