National Provider Identifier

Mario Mansour Matabele, MD

Mario Mansour Matabele, MD is listed in the NPPES registry with a primary specialty of Student in an Organized Health Care Education/Training Program in Rochester, NY and a listed phone number of (585) 275-2723.

NPI 1083318018Rochester, NYStudent in an Organized Health Care Education/Training Program

Profile Overview

NPI
1083318018
Provider Type
Individual
Primary Specialty
Student in an Organized Health Care Education/Training Program
Enumeration Date
March 27, 2023
Last Updated
March 27, 2023

Practice Location

  • 601 Elmwood Avenue Box Surg
  • Rochester, NY 14642-0001

Phone: (585) 275-2723

Mailing Address

  • 1322 Crowley Ave Apt 2
  • Madison, WI 53704-4210

Specialties

  • Student in an Organized Health Care Education/Training Program (390200000X)
Full Record
NPI
1083318018
Entity Type
Individual
Last Name
Matabele
First Name
Mario
Middle Name
Mansour
Name Prefix
Dr.
Credential
MD
Mailing Street Address
1322 Crowley Ave Apt 2
Mailing City
Madison
Mailing State
WI
Mailing ZIP Code
53704-4210
Mailing Country
US
Mailing Phone
(912) 220-1101
Practice Street Address
601 Elmwood Avenue Box Surg
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14642-0001
Practice Country
US
Practice Phone
(585) 275-2723
Enumeration Date
March 27, 2023
Last Updated
March 27, 2023
Sex
Male
Sole Proprietor
No
Certification Date
March 27, 2023
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Student in an Organized Health Care Education/Training Program (390200000X)