Individual
MR. RICHARD JOSEPH MATEYKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
699
NV
363AS0400X
Surgical Physician Assistant
Primary
PA699
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1912985367
—
NV
05
—
2402056
—
NV
01
—
970024992
R.R. MEDICARE
—
01
—
CC2485
BXBS
—
Enumeration date
01/05/2006
Last updated
10/15/2018
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