Individual
MATTHEW GREGORY KNOWLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
8401 MARKET ST, BOARDMAN, OH 44512-6725
(330) 729-2929
(330) 729-1841
Mailing address
4135 BOARDMAN CANFIELD RD, SUITE 101, CANFIELD, OH 44406-9803
(330) 286-5330
(330) 286-5396
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN372394
OH
367500000X
Certified Registered Nurse Anesthetist
RN604731
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING
MEDICARE PTAN
OH
05
—
PENDING
—
OH
Enumeration date
01/16/2014
Last updated
01/16/2014
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