Individual
MATTHEW BASIAGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
65452
MN
208000000X
Pediatrics Physician
74419
WI
208000000X
Pediatrics Physician
OS015978
PA
2080P0216X
Pediatric Rheumatology Physician
OP.60632322
WA
Other
Enumeration date
06/09/2009
Last updated
07/15/2021
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