Individual
JOSEPH SALVADOR MATARESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
301 HAWTHORNE LANE, SUITE 200, CONCORD, NC 28004
(704) 316-5100
(704) 316-5101
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 316-5100
(704) 316-5101
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-01142
NC
363AS0400X
Surgical Physician Assistant
0010-01142
NC
363AS0400X
Surgical Physician Assistant
1287
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942305446
—
NC
Enumeration date
09/13/2006
Last updated
11/27/2023
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