Provider Demographics
NPI:1013195759
Name:MATTEI, PETER L IV (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:L
Last Name:MATTEI
Suffix:IV
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8614 SR-70
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34202
Mailing Address - Country:US
Mailing Address - Phone:941-761-3334
Mailing Address - Fax:941-761-5818
Practice Address - Street 1:8614 SR-70
Practice Address - Street 2:SUITE 101
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34202
Practice Address - Country:US
Practice Address - Phone:941-779-3334
Practice Address - Fax:941-761-5818
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-05
Last Update Date:2023-08-29
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Provider Licenses
StateLicense IDTaxonomies
NC2015-02351207N00000X, 207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery