Individual
MATTHEW L DIVIETRO
Active
Individual
MATTHEW L DIVIETRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
O 0727
ID
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
O 0727
ID
207RP1001X
Pulmonary Disease Physician
Primary
O 0727
ID
Other
Enumeration date
05/16/2007
Last updated
08/24/2022
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