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Individual
JOHN QA MATTERN II
Active
Individual
JOHN QA MATTERN II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
0102024256
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005808855
—
VA
01
—
110054750
RAILROAD MEDICARE
VA
01
—
55097
OPTIMA
VA
Enumeration date
06/17/2005
Last updated
01/17/2019
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