Organization · NPI-2

Anjali Mathew MD PLLC

Internal Medicine · Moline, IL

NPI number1659901031
StatusActive
Last updated in NPPESMar 19, 2021

Details

NPI
1659901031
Entity type
Organization (NPI-2)
Legal business name
Anjali Mathew MD PLLC
Organization subpart
No
Enumeration date
Jan 24, 2020
Certification date
Mar 19, 2021
Last updated
Mar 19, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal Medicine––Yes

Practice location

615 35th Ave
Moline, IL 61265-6107

Phone 309-757-7780 · Fax 309-757-7719

Mailing address

47 Crabapple Ct
Iowa City, IA 52246-9408

Phone 917-617-4550

Other practice locations

47 Crabapple Ct
Iowa City, IA 52246-9408

Phone 917-617-4550

Authorized official

Anjali Mathew
Ceo
9176174550

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