Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | MT217207 | PA |
Y | 207RP1001X | Pulmonary Disease | MT217207 | PA |
NPI | 1013398940 |
---|---|
Provider Name | Dr. Atul Matta |
First Address | Philadelphia, PA 19141-3098 |
Second Address | Philadelphia, PA 19141 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2015 |
Last Update Date | 16/07/2019 |