Individual
DR. JOEL MICHAEL MATTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
181 W. MEADOW DRIVE, SUITE 400, VAIL, CO 81657
(970) 479-5843
(970) 237-3458
Mailing address
181 W. MEADOW DRIVE, SUITE 400, VAIL, CO 81657
(970) 479-5843
(970) 237-3458
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
G27855
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G278550
BLUE SHIELD
CA
Enumeration date
02/14/2007
Last updated
07/26/2018
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