Individual
MR. MATTHEW ALEXANDER NAMIHAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
802 AINSWORTH DR, SUITE A, PRESCOTT, AZ 86301-1623
(928) 776-0601
(928) 776-0620
Mailing address
PO BOX 61773, PHOENIX, AZ 85082-1773
(928) 445-6025
(928) 778-3026
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
3262
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
181976
—
AZ
01
—
WCSKQ
SUN HEALTH GROUP #
AZ
Enumeration date
07/07/2006
Last updated
11/01/2007
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