Provider Demographics
NPI:1649732702
Name:MATHUR, ABHAY (MD)
Entity type:Individual
Prefix:
First Name:ABHAY
Middle Name:
Last Name:MATHUR
Suffix:
Gender:
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:455 TOLL GATE RD
Mailing Address - Street 2:PRC AND CREDENTIALING
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-2759
Mailing Address - Country:US
Mailing Address - Phone:401-273-0641
Mailing Address - Fax:401-273-2919
Practice Address - Street 1:455 TOLL GATE RD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-2759
Practice Address - Country:US
Practice Address - Phone:401-729-2800
Practice Address - Fax:401-729-2877
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-05
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RIMD20562207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine