MAT GEORGIA, LLC


Address: 335 Roselane St Nw, Suite 203, Marietta, GA 30060-7902
Phone: 8182124659

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RA0401X Internal Medicine
Specialization: Addiction Medicine
Allopathic & Osteopathic Physicians

Office Location

Street Address 335 ROSELANE ST NW
SUITE 203
City MARIETTA
State GA
Zip Code 30060-7902

Providers in the same location

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
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 207RA0401X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Addiction Medicine

Taxonomy Definition

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

Providers in the same taxonomy and state

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
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Competitor

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City MARIETTA
Zip Code 30060

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Dataset Information

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.

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