Provider Demographics
NPI:1285843516
Name:NORMAN, MATTHEW WEST (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:WEST
Last Name:NORMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:12 PIEDMONT CTR NE STE 419
Mailing Address - Street 2:3495 PIEDMONT ROAD
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-1739
Mailing Address - Country:US
Mailing Address - Phone:404-495-5900
Mailing Address - Fax:404-495-5901
Practice Address - Street 1:12 PIEDMONT CTR NE STE 419
Practice Address - Street 2:3495 PIEDMONT ROAD
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-1739
Practice Address - Country:US
Practice Address - Phone:404-495-5900
Practice Address - Fax:404-495-5901
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA0461912084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAH00695Medicare UPIN
GA26BDHZCMedicare ID - Type Unspecified