Provider Demographics
NPI:1972593317
Name:MATTHEWS, PATRICIA (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1880 W OAK PKWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-2272
Mailing Address - Country:US
Mailing Address - Phone:770-795-8783
Mailing Address - Fax:770-795-7424
Practice Address - Street 1:4581 S COBB DR SE
Practice Address - Street 2:SUITE 100
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-6903
Practice Address - Country:US
Practice Address - Phone:770-801-5000
Practice Address - Fax:770-435-6680
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA056177208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics