Individual
DR. DOMINIC DEMATTEO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
132 ABIGAIL LN, PORT MATILDA, PA 16870-7153
(814) 272-7100
(814) 272-6501
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS007877L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01564476
—
PA
01
—
053949
AOA
PA
Enumeration date
04/19/2006
Last updated
08/31/2020
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