# MR. MATTHEW B DEWILD

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1023315090
- **Gender:** Man
- **Credential:** RN, LMT

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163W00000X | Registered Nurse | 090478 | IA | — |
| 163WI0500X | Infusion Therapy Registered Nurse | 090478 | IA | Yes |
| 163WX0106X | Occupational Health Registered Nurse | 090478 | IA | — |
| 225700000X | Massage Therapist | 006683 | IA | — |

## Other

- **Enumeration date:** 02/27/2011
- **Last updated:** 04/12/2022