Provider Demographics
NPI:1396707428
Name:MATHIS, JAMES GERTLER (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:GERTLER
Last Name:MATHIS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 16052
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19612-6052
Mailing Address - Country:US
Mailing Address - Phone:610-988-8589
Mailing Address - Fax:610-988-5976
Practice Address - Street 1:6TH AVE & SPRUCE ST
Practice Address - Street 2:
Practice Address - City:WEST READING
Practice Address - State:PA
Practice Address - Zip Code:19611
Practice Address - Country:US
Practice Address - Phone:610-988-8589
Practice Address - Fax:610-988-5976
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-04
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
PAMD025698E207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA239210Medicaid
484945Medicare ID - Type Unspecified
PA239210Medicaid