Provider Demographics
NPI:1114145083
Name:BARAL, MATTHEW IVY (ND)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:IVY
Last Name:BARAL
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1349 E PALMDALE DR
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-2655
Mailing Address - Country:US
Mailing Address - Phone:602-448-9499
Mailing Address - Fax:
Practice Address - Street 1:8010 E MCDOWELL RD
Practice Address - Street 2:SUITE 111
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85257-3867
Practice Address - Country:US
Practice Address - Phone:480-970-0000
Practice Address - Fax:480-970-0003
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ01-671175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath