Individual
ESTANISLAO ANTONIO MATOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
20 OLIVE ST, STE 401, AKRON, OH 44310-3194
(330) 376-3105
Mailing address
20 OLIVE ST, STE 401, AKRON, OH 44310-3194
(330) 376-3105
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35029796M
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0060437
—
OH
Enumeration date
01/19/2006
Last updated
04/21/2011
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