| Provider / Organization | NPI | Date Certified |
|---|---|---|
| ANNA MATRACHISIA | 1407203300 | 2024-09-06 |
Anna Matrachisia is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1407203300. Registration indicates Anna Matrachisia is a provider of services with a specialization in Allopathic & Osteopathic Physicians, Colon & Rectal Surgery (Colon & Rectal Surgery, ) (Specialist Network, ) (Colon & Rectal Surgery, Allopathic & Osteopathic Physicians) (Allopathic & Osteopathic Physicians, Colon & Rectal Surgery) (Colon & Rectal Surgery, ) (Specialist Network, ) (Colon & Rectal Surgery, Allopathic & Osteopathic Physicians)
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Anna Matrachisia M.D. |
| Other Provider Name | Anna Kukhta |
| Practice Office Address | 300 CALLEN BLVD STE 220 SUMMERVILLE, SC US |
| Practice Office Telephone | 8439581281 |
| Practice Office Fax | 8439581278 |
| Mailing Address | PO BOX 751649 CHARLOTTE, NC 282751649 US |
| Business Telephone | 8884720043 |
| Business Fax | 8437242440 |
| Code | Practice | License No State |
|---|---|---|
| 208C00000X PRIMARY | Allopathic & Osteopathic Physicians Colon & Rectal Surgery Colon & Rectal Surgery Specialist Network Colon & Rectal Surgery Allopathic & Osteopathic Physicians | 39423
SC |
| 208C00000X | Allopathic & Osteopathic Physicians Colon & Rectal Surgery Colon & Rectal Surgery Specialist Network Colon & Rectal Surgery Allopathic & Osteopathic Physicians | 0101275631
VA |
| 193400000X SING | Group Code |