Individual
MR. KANE MATTHEW DEEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1511 GRANT AVE, GARDNERVILLE, NV 89410-7824
(775) 445-7220
Mailing address
1460 SOUTH CURRY STREET, SUITE 100, CARSON CITY, NV 89703
(775) 883-3336
(775) 883-0877
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
V36326
—
NV
Enumeration date
01/23/2006
Last updated
05/29/2019
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