Timothy D Matthew CRNA

NPI 1912017070 - Nurse Anesthetist, Certified Registered - 367500000X

NPI Details
NPI 1912017070
Gender Male
Enumeration Date 08/30/2006
Last Updated 01/03/2013
Entity Type Individual
Active Over 10 years ago
Practice Location
353 FAIRMONT BLVD
RAPID CITY SD, 57701, US
Phone (605) 719-1000
Fax
Business Location
353 FAIRMONT BLVD
ATTEN MEDICAL STAFF SERVICES
RAPID CITY SD, 57701-6000, US
Phone
Fax
Toxanomy
Taxonomy Code 367500000X
License State South Dakota
License Number R029305
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According to our database, Timothy D Matthew CRNA NPI is 1912017070, taxonomy code is 367500000X and license number is R029305, license state is located at South Dakota. Timothy D Matthew CRNA physically located at 353 Fairmont Blvd, Rapid City SD, 57701. NPI Number Timothy D Matthew CRNA has the Individual type.

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1912017070 NPI number is provided on an as is basis without warranty of any kind. 1912017070 is maintained by the National Plan & Provider Enumeration System. The contents of Timothy D Matthew CRNA are for informational purposes only.