Individual
MICHAEL A MATYAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8020 CONSTITUTION PL NE, SUITE 202, ALBUQUERQUE, NM 87110-7607
(505) 998-3096
(505) 998-3100
Mailing address
8020 CONSTITUTION PL NE, SUITE 202, ALBUQUERQUE, NM 87110-7607
(505) 998-3096
(505) 998-3100
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
H8241
TX
2085R0202X
Diagnostic Radiology Physician
Primary
MD2013-0288
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118189304
—
TX
01
—
293460YLGQ
MEDICARE
NM
01
—
293460YN90
MEDICARE
NM
Enumeration date
05/31/2005
Last updated
08/12/2013
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