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Individual

DR. CLIFFORD M MATUSHIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
919 NORTHLAND DR, PRINCETON, MN 55371-2172
(763) 389-3344
Mailing address
919 NORTHLAND DR, PRINCETON, MN 55371-2172
(763) 389-3344

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
107306
MN
207R00000X
Internal Medicine Physician
3575
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
107306
MINNESOTA LICENSE
MN
01
3575
STATE LICENSE
SD
05
6002770
SD
Enumeration date
02/15/2006
Last updated
01/07/2014
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