Individual
COLLEEN MATEJICKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
OS009984L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018997900001
—
PA
01
—
1062166
AETNA HMO
PA
01
—
1390245
HIGHMARK BLUE SHIELD
PA
01
—
1527199
GATEWAY HEALTH PLAN
PA
01
—
50000922
CAPITAL BLUE CROSS
PA
01
—
7990688
AETNA NON-HMO
PA
01
—
H62859
HEALTH ASSURANCE
PA
Enumeration date
11/22/2005
Last updated
08/21/2007
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