Individual
DR. IPPOLIT C MATJUCHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
36 MARK LN, SUDBURY, MA 01776-1677
(978) 440-8729
Mailing address
36 MARK LN, SUDBURY, MA 01776-1677
(978) 440-8729
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
80011
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3128059
—
MA
Enumeration date
09/26/2006
Last updated
01/06/2011
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