Carpenter, Matthew D
Carpenter, Matthew D is an sole proprietor health care provider with primary practice located at 677 Church St Ne , Marietta GA 30060-1101. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Anesthesiologist Assistant, which is considered as his primary health care specialty. Carpenter, Matthew D can be contacted via phone (770) 794-0477.Contact Information
Primary practice address
677 Church St Ne
Marietta GA 30060-1101
Phone: (770) 794-0477
Fax: (770) 794-3108
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Anesthesiologist Assistant | 367H00000X | 004372 | Georgia |
Profile Details
| NPI number | 1053366120 |
|---|---|
| LBN Legal business name | Carpenter, Matthew D |
| Credentials | AAC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 24th, 2006 |
| Last updated | Aug 27th, 2019 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053366120 | NPPES |
| Georgia | MEDICAID | 904409222B | |
| Georgia | MEDICAID | 904409222A |
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