Individual
MATTHEW CARL SOLLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1024 S LEMAY AVE, FORT COLLINS, CO 80524-3929
(303) 306-7783
(303) 306-7753
Mailing address
PO BOX 912215, DENVER, CO 80291-2215
(303) 306-7783
(303) 306-7753
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
45259
CO
207P00000X
Emergency Medicine Physician
A90129
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A901290
—
CA
05
—
125171600
—
WY
05
—
62554824
—
CO
01
—
P00451301
RAILROAD MEDICARE
—
01
—
S5008
BCBS
—
Enumeration date
05/31/2006
Last updated
03/07/2014
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