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Individual

IGOR EVAN MATWIJIW

Active
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Individual

IGOR EVAN MATWIJIW

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
J4910
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
126488902
—
TX
05
—
126488906
—
TX
05
—
200298690A
—
OK
01
—
4321815
AETNA
TX
01
—
460002032
RAILROAD MEDICARE
TX
01
—
87281J
BCBS
TX
01
—
87592Z
HMO BLUE
TX
Enumeration date
09/02/2005
Last updated
06/22/2021
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