Mattson, Mark Warren

Mattson, Mark Warren is an individual health care provider with primary practice located at 225 Hospital Drive , Galax VA 24333-2228. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Mattson, Mark Warren can be contacted via phone (276) 236-6906.

Contact Information

Primary practice address
225 Hospital Drive Galax VA 24333-2228
Phone: (276) 236-6906
Fax: (276) 236-7179
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 0101030930 Virginia
Allopathic & Osteopathic Physicians / Surgery 208600000X 22944 North Carolina

Profile Details

NPI number 1902900079
LBN Legal business name Mattson, Mark Warren
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 11th, 2006
Last updated Feb 11th, 2015 - about 10 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902900079 NPPES
Virginia MEDICAID 007335288

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