Individual
JOHN MATZKO
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3949 BROWNING PL, RALEIGH, NC 27609-6504
(919) 787-8221
(919) 789-4461
Mailing address
PO BOX 19368, RALEIGH, NC 27619-9368
(919) 787-8221
(919) 789-4461
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
96-00631
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16-54618
UNITED HEALTHCARE
NC
01
—
16-54619
UNITED HEALTHCARE
NC
01
—
16-54620
UNITED HEALTHCARE
NC
01
—
54833
BLUECROSS BLUESHIELD
NC
01
—
64595
MEDCOST
NC
01
—
64597
MEDCOST
NC
01
—
64599
MEDCOST
NC
05
—
8954833
—
NC
Enumeration date
06/07/2006
Last updated
07/08/2007
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