Maternal Gynerations, PC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

MATERNAL GYNERATIONS, PC

Practice address

761 Old Norcross Rd
Lawrenceville, GA 30046-4317

Phone

(770) 513-4000

Fax

(770) 995-3495

NPI assigned

Jan 31, 2007

Organization subpart

No

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

Authorized official

Name

Lance J Wiist

Title

Vice President

Phone

(770) 513-4000

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323993600000",
    "number": "1689711558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "761 OLD NORCROSS RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464317",
            "telephone_number": "770-513-4000",
            "fax_number": "770-995-3495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "761 OLD NORCROSS RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464317",
            "telephone_number": "770-513-4000",
            "fax_number": "770-995-3495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATERNAL GYNERATIONS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2011-12-16",
        "status": "A",
        "authorized_official_last_name": "WIIST",
        "authorized_official_first_name": "LANCE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "770-513-4000"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA RAILROAD",
            "identifier": "CJ3628",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rudolph Amadeus Mason, M.D.
• Masscare DME Solutions Inc
• Alexcia Massey, LPC
• Romeo Pius Massoud, MD
• Maternal Gynerations 2 LLC
• Antoinette Kara Matheson, LPN
• Benita Merin Mathew, CAA
• Jayce Mathew, DDS
• Jose Mathew, DO, MPH
• Lekha Mathew, MD

• Obstetrics & Gynecology Physician in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Obstetrics & Gynecology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2011; 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.