Basic Information
| Provider Information | |||||||||
| NPI: | 1861529380 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MATOS | ||||||||
| FirstName: | RAMON | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2 SOUTH AVE | ||||||||
| Address2: | |||||||||
| City: | CARTERSVILLE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 301203559 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7703870544 | ||||||||
| FaxNumber: | 7703870543 | ||||||||
| Practice Location | |||||||||
| Address1: | 960 JOE FRANK HARRIS PKWY SE | ||||||||
| Address2: | ANESTHESIA DEPT | ||||||||
| City: | CARTERSVILLE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 301202129 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7703821530 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/28/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 057543 | GA | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.