Ms Nicole Marie Matala, MS, RD, LDN | |
212 S Salem St, Apex, NC 27502-1825 | |
(919) 362-5201 | |
Not Available |
Full Name | Ms Nicole Marie Matala |
---|---|
Gender | Female |
Speciality | Registered Dietitian Or Nutrition Professional |
Experience | 13 Years |
Location | 212 S Salem St, Apex, North Carolina |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1578819041 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
133V00000X | Dietitian, Registered | L003997 (North Carolina) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Raleigh Medical Group Pa | 6800874322 | 98 |
Provider Name | Raleigh Medical Group Pa |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1104962315 PECOS PAC ID: 6800874322 Enrollment ID: O20040712000418 |
Mailing Address | Practice Location Address |
---|---|
Ms Nicole Marie Matala, MS, RD, LDN 2620 New Bern Ave, Raleigh, NC 27610-1821 Ph: (919) 255-6721 | Ms Nicole Marie Matala, MS, RD, LDN 212 S Salem St, Apex, NC 27502-1825 Ph: (919) 362-5201 |
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