Provider Demographics
NPI:1073506853
Name:MATSKO, ROBERT PAUL SR (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:PAUL
Last Name:MATSKO
Suffix:SR
Gender:M
Credentials:DO
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Mailing Address - Street 1:205 GRANDVIEW AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-1708
Mailing Address - Country:US
Mailing Address - Phone:717-972-7917
Mailing Address - Fax:717-972-4470
Practice Address - Street 1:211 BROAD ST
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17053-1302
Practice Address - Country:US
Practice Address - Phone:717-957-3500
Practice Address - Fax:717-957-4069
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2011-03-22
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Provider Licenses
StateLicense IDTaxonomies
PAOS002859L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAC31859Medicare UPIN