Mattis, Fallon Andrea
Mattis, Fallon Andrea is an individual health care provider with primary practice located at 101 Aubreys Loop Sentara Halifax Family Medicine, South Boston VA 24592-5054. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Mattis, Fallon Andrea can be contacted via phone (646) 835-9001.Contact Information
Primary practice address
101 Aubreys Loop Sentara Halifax Family Medicine
South Boston VA 24592-5054
Phone: (646) 835-9001
Fax: (646) 835-9001
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | R7061 | Texas |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 63188 | Minnesota |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 036144488 | Illinois |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 2017034134 | Missouri |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 10501937-1205 | Utah |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 273617-1 | New York |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 25MA10713600 | New Jersey |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 0101257845 | Virginia |
Profile Details
| NPI number | 1558686345 |
|---|---|
| LBN Legal business name | Mattis, Fallon Andrea |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 5th, 2010 |
| Last updated | Oct 30th, 2019 - about 5 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 | 1558686345 | NPPES |
| New York | Other | 1558686345 | FAMILY MEDICINE |
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