Provider Demographics
NPI:1851509012
Name:MATHEW, SANTHIA A (MD)
Entity Type:Individual
Prefix:
First Name:SANTHIA
Middle Name:A
Last Name:MATHEW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5500 KNOLL NORTH DR
Mailing Address - Street 2:SUITE 370
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-2370
Mailing Address - Country:US
Mailing Address - Phone:410-884-7831
Mailing Address - Fax:410-715-3734
Practice Address - Street 1:5500 KNOLL NORTH DR
Practice Address - Street 2:SUITE 370
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-2370
Practice Address - Country:US
Practice Address - Phone:410-884-7831
Practice Address - Fax:410-715-3734
Is Sole Proprietor?:No
Enumeration Date:2007-05-20
Last Update Date:2010-10-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0071095207Q00000X
DCMD038507207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine