Provider Demographics
NPI:1255960217
Name:HESSE, MATILDA ADOBEA (MD)
Entity type:Individual
Prefix:
First Name:MATILDA
Middle Name:ADOBEA
Last Name:HESSE
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 1:5828 BROADWAY ST APT 827
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:NY
Mailing Address - Zip Code:14086-9245
Mailing Address - Country:US
Mailing Address - Phone:646-301-4095
Mailing Address - Fax:
Practice Address - Street 1:1005 DR. D.B. TODD JR. BOULEVARD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37208
Practice Address - Country:US
Practice Address - Phone:615-327-6277
Practice Address - Fax:615-327-6733
Is Sole Proprietor?:No
Enumeration Date:2020-04-02
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD481767207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine