MAT GEORGIA, LLC (NPI# 1356797666) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1356797666 |
Entity Type | Organization |
Organization Name | MAT GEORGIA, LLC |
Practice Address |
335 Roselane St Nw Suite 203 Marietta GA 30060-7902 |
Mailing Address |
1290 Kennestone Cir Suite A112 Marietta GA 30066-6009 |
Practice Telephone | 8182124659 |
Enumeration Date | 2016-05-05 |
Last Update Date | 2016-05-05 |
Authorized Official Name | VICTOR ALFONSO (CEO) |
Authorized Official Telephone | 8182124659 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207RA0401X |
Internal Medicine Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians |
Street Address |
335 ROSELANE ST NW SUITE 203 |
City | MARIETTA |
State | GA |
Zip Code | 30060-7902 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609851773 | Arnold Jay Weil | Physical Medicine & Rehabilitation | 335 Roselane St Nw, Marietta, GA 30060-6969 | 2005-12-13 |
1912557935 | Cygni, LLC | Clinic/Center | 335 Roselane St Nw, Marietta, GA 30060-7902 | 2019-09-12 |
1932635570 | Emily Macfarlane | Physical Therapy Assistant | 335 Roselane St Nw, Suite #201, Marietta, GA 30060-7902 | 2017-05-02 |
1396198412 | Jillian A Mossner | Nurse Practitioner | 335 Roselane St Nw, Marietta, GA 30060-7902 | 2016-07-14 |
1346595741 | Ikram Malik | Physical Medicine & Rehabilitation | 335 Roselane St Nw, Marietta, GA 30060-7902 | 2012-07-21 |
1508176108 | Laura Beth Perelman | Physical Therapist | 335 Roselane St Nw, Marietta, GA 30060-7902 | 2010-10-15 |
1780735175 | The Center for Spine Procedures, PC | Clinic/Center | 335 Roselane St Nw, Marietta, GA 30060-6969 | 2007-01-15 |
1871656561 | Non-surgical Orthopaedics PC | Specialist | 335 Roselane St Nw, Marietta, GA 30060-6969 | 2006-12-18 |
1528147337 | Megan Ford | Physical Therapist | 335 Roselane St Nw, Ste. 201, Marietta, GA 30060-6969 | 2006-11-03 |
1538194584 | Lisa Eichler | Physical Therapist | 335 Roselane St Nw, Suite 201, Marietta, GA 30060-6969 | 2006-07-11 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144845116 | Legacy Center for Spinal Surgery, LLC | Neurological Surgery | 1900 The Exchange, Ne, Suite 600, Marietta, GA 30060 | 2020-06-15 |
1407477193 | Michael Cynil Daniel | Counselor | 698 N Marietta, Pkwy, Marietta, GA 30060 | 2020-05-04 |
1285253401 | Cameron Thomas Kennelly | Student in an Organized Health Care Education/Training Program | 677 Church Street Ne Attn:gme, Marietta, GA 30060 | 2020-04-09 |
1922640739 | Jeremiah George Blair | Physician Assistant | 61 Whitcher St Suite 2100, Marietta, GA 30060 | 2019-10-14 |
1164064945 | Denise Alicia Mick | Registered Nurse | 677 Church St Wellstar Kennestone Hospital, Marietta, GA 30060 | 2019-10-12 |
1184283772 | Iora Health Georgia, P.C. | Internal Medicine | 280 Cobb Pkwy Se, Suite 60, Marietta, GA 30060 | 2019-06-07 |
1346703212 | Caitlin Virginia Mueller | Student in an Organized Health Care Education/Training Program | 677 Church Street Ne, Attn: Gme, Marietta, GA 30060 | 2019-04-08 |
1184187205 | Adero Francis | Student in an Organized Health Care Education/Training Program | Wellstar Kennestone Gme Internal Medicine Clinic, 833 Campbell Hill St Nw, Suite 250, Marietta, GA 30060 | 2019-04-08 |
1659832749 | Matthew Mozzo | Student in an Organized Health Care Education/Training Program | 677 Church Street / Lower Level, Gme Department / I.m., Marietta, GA 30060 | 2019-03-29 |
1245797430 | La'myia Spentz | Specialist | 109 Anderson St Ne, Suite 608, Marietta, GA 30060 | 2019-02-25 |
Find all providers in zip 30060 |
Taxonomy Code | 207RA0401X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Addiction Medicine |
An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. |
Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669026837 | Barry Howard Lubin | Internal Medicine | 1150 Collier Rd Nw Apt H20, Atlanta, GA 30318-2938 | 2019-07-26 |
1558887018 | Miguel E. Stubbs, Md PC | Internal Medicine | 4760 Austell Rd Ste 1, Austell, GA 30106-2007 | 2017-08-16 |
1760401756 | Kimberlynn R Richards | Internal Medicine | 3634 Highlands Pkwy Se, Smyrna, GA 30082-5184 | 2006-07-19 |
1336167600 | Shawn Ray Williams | Internal Medicine | 311 Jones Mill Rd, Statesboro, GA 30458-4765 | 2006-07-17 |
1245748771 | Emanuel Counseling Services, Inc | Internal Medicine | 105 Warren Ave, Swainsboro, GA 30401-3645 | 2018-01-18 |
1295288124 | Peach Medical Systems Associates LLC | Internal Medicine | 4500 N Point Pkwy, Alpharetta, GA 30022-2409 | 2016-07-27 |
1437502143 | Whole and Healthy Youth, LLC | Internal Medicine | 3200 Highlands Pkwy Se, Suite 400, Smyrna, GA 30082-5166 | 2016-07-18 |
1841650538 | Personal Recovery Network LLC | Internal Medicine | 4015 S Cobb Dr Se, Smyrna, GA 30080-6303 | 2016-02-24 |
1275945909 | Alisha Goodrum | Internal Medicine | 101 Quartz Dr Ste 201, Villa Rica, GA 30180-3256 | 2014-05-29 |
1659537165 | Emory Medical Care Foundation Inc | Internal Medicine | 80 Jesse Hill Jr Dr Se, Atlanta, GA 30303-3031 | 2008-08-04 |
Find all providers with the same taxonomy |
Please comment or provide details below to improve the information on MAT GEORGIA, LLC.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.