Individual
FUMISUKE MATSUO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
157923-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
756133008
RAILROAD MEDICARE
UT
Enumeration date
10/13/2006
Last updated
01/25/2008
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