Mitchell Vincent Mathis Jr., M.D.

Primary specialty

Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X

License

D0051608 Issued in MD

Practice address

10630 Little Patuxent Parkway
Suite 209
Columbia, MD 21044

Phone

(410) 740-8066

Fax

(410) 740-8068

NPI assigned

Dec 4, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333584000000",
    "number": "1588846232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10630 LITTLE PATUXENT PARKWAY",
            "address_2": "SUITE 209",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "21044",
            "telephone_number": "410-740-8066",
            "fax_number": "410-740-8068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10630 LITTLE PATUXENT PARKWAY",
            "address_2": "SUITE 209",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "21044",
            "telephone_number": "410-740-8066",
            "fax_number": "410-740-8068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIS",
        "first_name": "MITCHELL",
        "middle_name": "VINCENT",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-04",
        "last_updated": "2012-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TP0016X",
            "taxonomy_group": "",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "MD",
            "license": "D0051608",
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "MD",
            "license": "D0051608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Mathason, LMT
• Santhia A. Mathew, MD
• Ann Marie Mathews, M.S., CCC/SLP
• Deborah Mathias
• Gloria Lee Mathis
• Sanjog Kumar Mathur, M.D.
• Imani Mathurin
• Danielle K Matilsky, MD
• Sababa Matin
• Christine Syokau Mativo, M.D.

• Geriatric Psychiatry Physician in Columbia, MD
• Providers in Columbia, MD by specialty
• Geriatric Psychiatry Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2012; 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.