MEDICARE: MATTHEW IGBINIGIE 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
1	207X00000X	Orthopaedic Surgery Physician	A195139	CA
2	207XS0117X	Orthopaedic Surgery of the Spine Physician	A195139	CA
3	207XS0117X	Orthopaedic Surgery of the Spine Physician	105593	GA

General Provider Information

NPI Number	:	1700383486
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW IGBINIGIE MD

Provider Business Mailing Address
First Line	:	939 BOB ARNOLD BLVD STE A
Second Line	:
City	:	LITHIA SPRINGS
State	:	GA
Zip	:	30122-3258
Country	:	US
Telephone Number	:	770-769-1724
Fax Number	:

Provider Business Practice Location Address
First Line	:	939 BOB ARNOLD BLVD STE A
Second Line	:
City	:	LITHIA SPRINGS
State	:	GA
Zip	:	30122-3258
Country	:	US
Telephone Number	:	770-769-1724
Fax Number	:

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

Provider Enumeration Date	:	04/10/2018
Last Update Date	:	04/08/2026

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Directions to “ MATTHEW IGBINIGIE MD” Practice Location

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