Provider Demographics
NPI:1346413648
Name:POMBO, MATHEW WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:MATHEW
Middle Name:WILLIAM
Last Name:POMBO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3855 PLEASANT HILL RD STE 470
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-1417
Mailing Address - Country:US
Mailing Address - Phone:770-813-8888
Mailing Address - Fax:
Practice Address - Street 1:3855 PLEASANT HILL RD STE 470
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-1417
Practice Address - Country:US
Practice Address - Phone:770-813-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-08
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT191685207XX0005X
GA61262207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine