Individual
DR. MATTHEW L MATTERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1350 S HICKORY ST, HRMC/RADIOLOGY DEPT., MELBOURNE, FL 32901-3224
(321) 434-7313
(321) 434-7238
Mailing address
PO BOX 2400, MELBOURNE, FL 32902-2400
(321) 434-4600
(321) 259-0635
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
ME107913
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003692000
—
FL
Enumeration date
01/03/2008
Last updated
08/05/2013
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