Individual
DR. MATHEW M JOSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1015 S BLACKHOOF ST, WAPAKONETA, OH 45895-2209
(419) 738-3317
(419) 738-5952
Mailing address
1015 S BLACKHOOF ST, PO BOX 39, WAPAKONETA, OH 45895-2209
(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
—
2060915
—
OH
01
—
P00623951
RAILROAD MEDICARE PIN
OH
Enumeration date
03/02/2006
Last updated
04/04/2011
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