Individual
DR. MATTHEW JOSEPH BARULICH III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2170 SOUTH AVE, SOUTH LAKE TAHOE, CA 96150-7026
(775) 882-8487
(775) 882-8487
Mailing address
PO BOX 2046, CARSON CITY, NV 89702-2046
(775) 882-8487
(775) 882-8487
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
5413
NV
207V00000X
Obstetrics & Gynecology Physician
Primary
A40451
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002013051
—
NV
01
—
160055464
MEDICARE RAILROAD
—
Enumeration date
10/18/2005
Last updated
12/31/2013
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