Individual
MATTHEW SIZEMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
18251 N 39TH DR, GLENDALE, AZ 85308-1807
(757) 642-6296
Mailing address
18251 N 39TH DR, GLENDALE, AZ 85308-1807
(757) 642-6296
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1147350
—
CA
Enumeration date
08/01/2017
Last updated
08/01/2017
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