Annakutty Mathew, M.D.

Individual provider Active NPI Infectious Disease Physician · Tamuning, GU

NPI 1124246152 · NPPES record last updated Oct 29, 2010

Key facts

NPI
1124246152
Entity type
Individual (NPI type 1)
Primary specialty
Infectious Disease Physician 207RI0200X
License
M-941 (GU)
Practice address
850 Gov. Carlos Camacho Rd.
Tamuning, GU 96913-3128
Phone
(671) 647-2330
NPI assigned
Apr 23, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X M-941 GU Yes

Addresses

Primary practice location

850 Gov. Carlos Camacho Rd.
Tamuning, GU 96913-3128

Mailing address

159 Trenton Way
Tamuning, GU 96913-3163

Other providers in Tamuning, GU

All providers in Tamuning, GU · Infectious Disease Physician in Guam

Sources for this page

Verify at the official NPI Registry.