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Individual

DR. MATTHEW S SPIVA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
US HWY 491 NORTH, SHIPROCK, NM 87420
(505) 368-6001
Mailing address
PO BOX 160, SHIPROCK, NM 87420-0160
(505) 368-6001

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
8718615-0501
UT
213E00000X
Podiatrist
Primary
POD387
NM
213ES0103X
Foot & Ankle Surgery Podiatrist
8718615-0501
UT
213ES0103X
Foot & Ankle Surgery Podiatrist
POD387
NM

Other

Enumeration date
06/22/2012
Last updated
10/10/2018
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