Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 1546 | NE |
N | 207PE0004X | Emergency Medical Services | S5609 | TX |
NPI | 1114318318 |
---|---|
Provider Name | Dr. Matthew Thomas Esposito |
First Address | Fort Stewart, GA 31314-5641 |
Second Address | Fort Stewart, GA 31314-5641 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2015 |
Last Update Date | 21/10/2020 |