Mat Georgia, LLC

Primary specialty

Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X

Legal business name

MAT GEORGIA, LLC

Practice address

335 Roselane St NW
Suite 203
Marietta, GA 30060-7902

Phone

(818) 212-4659

NPI assigned

May 5, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Victor Alfonso

Title

Ceo

Phone

(818) 212-4659

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1462406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462406400000",
    "number": "1356797666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1290 KENNESTONE CIR",
            "address_2": "SUITE A112",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300666009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 ROSELANE ST NW",
            "address_2": "SUITE 203",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300607902",
            "telephone_number": "818-212-4659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAT GEORGIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-05",
        "last_updated": "2016-05-05",
        "status": "A",
        "authorized_official_last_name": "ALFONSO",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-212-4659"
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Priti Roopam Master, DPT
• Masterpiecewithin
• Lindsy Marie Masters, DPT
• Vivian Masters, CNM
• Gena Marie Mastrogianakis, M.D.
• Roseline Matanmi
• John Matechak, DO
• Mateo Family Services, LLC
• Martynas Matevicius, DC
• Jessica Mathew

• Addiction Medicine (Internal Medicine) Physician in Marietta, GA
• Providers in Marietta, GA by specialty
• Addiction Medicine (Internal Medicine) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.