Provider Demographics
NPI:1538327119
Name:WHALIN, MATTHEW KEITH (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:KEITH
Last Name:WHALIN
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 JESSE HILL JR DR SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303-3031
Mailing Address - Country:US
Mailing Address - Phone:404-616-5519
Mailing Address - Fax:404-616-9213
Practice Address - Street 1:80 JESSE HILL JR DR SE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-3031
Practice Address - Country:US
Practice Address - Phone:404-616-5519
Practice Address - Fax:404-616-9213
Is Sole Proprietor?:No
Enumeration Date:2008-05-30
Last Update Date:2012-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA067628207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology