Individual
MR. MATTHEW MEMMOTT NEDDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C, MPAS
Contact information
Practice address
2500 S LAKE PARK BLVD, WEST VALLEY CITY, UT 84120-8218
(801) 902-4238
(801) 266-6916
Mailing address
5080 SPECTRUM DR STE 1200W, ADDISON, TX 75001-4624
(972) 364-8000
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
373676-1206
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
373676-1206
STATE LICENSE
UT
Enumeration date
12/21/2006
Last updated
11/16/2023
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