Individual
DR. ETHAN LESTER MATZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-0423
Mailing address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-0423
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
U1083
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/19/2018
Last updated
10/16/2023
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