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Contact Information

FAZLE MATIN, MD
203 WEST LEE STREET
TUSKEGEE, AL36083
 Phone: 334-727-7050
 Fax: 334-727-6284
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for FAZLE MATIN · (Male)

NPI Number 1053452417
Status Active
Credentials MD
Entity Individual
Enumeration date 02/09/2007
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • AL License # 00022310
  • AL Medicaid 631000021
  • AL Other 51005213 BC
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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