Individual
DR. MATTHEW AARON BURTELOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2367
(208) 381-4762
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2367
(208) 381-4762
Taxonomy
Speciality
Code
Description
License number
State
207ZC0006X
Clinical Pathology Physician
A88725
CA
207ZP0101X
Anatomic Pathology Physician
A88725
CA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
60022117
WA
Other
Enumeration date
10/10/2007
Last updated
07/29/2009
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