Individual
DEREK MATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
77 GOODELL ST, BUFFALO, NY 14203-1243
(716) 829-6104
Mailing address
77 GOODELL ST, BUFFALO, NY 14203-1243
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0102206668
VA
Other
Enumeration date
04/17/2017
Last updated
03/21/2024
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