Individual
DR. MICHAEL E MATLAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
1605921205
UT
2086S0120X
Pediatric Surgery Physician
Primary
1605921205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05572
—
UT
Enumeration date
10/18/2006
Last updated
06/02/2008
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