Organization
MATHEW M. JOSE, M.D., INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATHEW M JOSE M.D. (OWNER)
(419) 738-3317
Entity
Organization
Contact information
Practice address
1015 S BLACKHOOF ST, WAPAKONETA, OH 45895-2209
(419) 738-3317
(419) 738-5952
Mailing address
PO BOX 39, WAPAKONETA, OH 45895-0039
(419) 738-3317
(419) 738-5952
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35072597J
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2834893
—
OH
01
—
DN5206
RAILROAD MEDICARE GROUP PTAN
OH
Enumeration date
09/05/2006
Last updated
04/04/2011
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