Individual
MATHEW SEVERIDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
122 4TH AVE, GRINNELL, IA 50112-1829
(641) 236-4323
(641) 236-0680
Mailing address
122 4TH AVE, GRINNELL, IA 50112-1829
(641) 236-4323
(641) 236-0680
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
4098
IA
208600000X
Surgery Physician
Primary
4098
IA
Other
Enumeration date
07/16/2008
Last updated
04/19/2021
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