Doctor Name: | EUGENIO B MATOS |
NPI Number: | 1023128444 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 41998 |
Business Practice Address: | 1210 W 18th St Ste 100 Sioux Falls, SD - 571049890 |
Business Phone Number: | 6053128500 |
Business Fax Number: | 6053128501 |
Mailing Address: | Po Box 5074, SIOUX FALLS |
State: | SD |
Postal Code: | 571175074 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 08/30/2006 |
NPI Last Update Date: | 10/08/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 41998 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MN |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |