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Individual

DR. MATTHEW V ZACCHEO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
111 S FRONT ST, HARRISBURG, PA 17101-2010
(717) 231-8772
(717) 231-8435
Mailing address
111 S FRONT ST, HARRISBURG, PA 17101-2010
(717) 231-8772
(717) 231-8435

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
OS012450
PA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
5101018545
MI
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
OS012450
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00027186402
UNIVERA
NY
01
02833796
NY MEDICAID
NY
05
1010579960002
PA
05
1033173267
MI
01
1071104
W. VIRGINIA WORKERS COMP
WV
05
1255304358
MI
01
1417961137
BCBSM - BMH TAX ID
MI
01
1427756
AETNA
PA
01
1540527
GATEWAY
PA
01
1633761
BLUE SHIELD
PA
01
197616
UNISON
PA
01
2702892
OH MEDICAID
OH
01
410337
UPMC
PA
01
P00380522
RR MEDICARE
PA
Enumeration date
04/14/2006
Last updated
08/14/2021
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