Individual
MATTHEW A. SIWICKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
186 HOSPITAL DR, GRANTSVILLE, WV 26147-7100
(304) 354-9244
(304) 354-9323
Mailing address
186 HOSPITAL DR, GRANTSVILLE, WV 26147-7100
(304) 354-9244
(304) 354-9323
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP0005958
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RP0005958
PHARMACIST
WV
Enumeration date
01/18/2007
Last updated
07/08/2007
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