| Matthew Smith Md Pc | |
|
1753 W Ridgeway Ave Ste 103a Waterloo IA 50701-4521 | |
| (319) 235-3568 | |
| (319) 235-5013 |
| Full Name | Matthew Smith Md Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 1753 W Ridgeway Ave Ste 103a, Waterloo, Iowa |
| Authorized Official Name and Position | Matthew Smith (MD) |
| Authorized Official Contact | 3192353568 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Matthew Smith Md Pc Po Box 2818 Waterloo IA 50704-2818 Ph: () - | Matthew Smith Md Pc 1753 W Ridgeway Ave Ste 103a Waterloo IA 50701-4521 Ph: (319) 235-3568 |
| NPI Number | 1154072379 |
|---|---|
| Provider Enumeration Date | 01/11/2022 |
| Last Update Date | 01/11/2022 |
| Medicare PECOS PAC ID | 8022402411 |
|---|---|
| Medicare Enrollment ID | O20220301001011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154072379 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Matthew J Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609876507 PECOS PAC ID: 1355322199 Enrollment ID: I20040526001718 |
| Provider Name | Chi-ying Diana Sage |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831722370 PECOS PAC ID: 4082044995 Enrollment ID: I20200416002626 |
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