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Individual
DR. OTAKHON MATCHANOV
Active
Individual
DR. OTAKHON MATCHANOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2084N0600X
Clinical Neurophysiology Physician
338571-01
NY
208M00000X
Hospitalist Physician
Primary
ME182444
FL
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
131804200
—
FL
Enumeration date
03/03/2021
Last updated
08/21/2026
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