Mathew, Susan P.

Mathew, Susan P. is an individual health care provider with primary practice located at 201 Clyde Morris Blvd. , Daytona Beach FL 32114-2709. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medical Services, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Emergency Medical Services is her primary health care specialty. Mathew, Susan P. can be contacted via phone (386) 676-7130.

Contact Information

Primary practice address
201 Clyde Morris Blvd. Daytona Beach FL 32114-2709
Phone: (386) 676-7130
Fax: (386) 676-7125
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X 031212 Connecticut
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 031212 Connecticut

Profile Details

NPI number 1770675480
LBN Legal business name Mathew, Susan P.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 29th, 2006
Last updated Oct 27th, 2010 - about 16 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 1770675480 NPPES
Connecticut MEDICAID 4041679
Connecticut Other 060646704
Connecticut MEDICAID 4024972
Connecticut MEDICAID 1770675480
Connecticut Other 010031212CT

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