Provider Demographics
NPI:1114918919
Name:WESTERFIELD, MATTHEW DEAN (DPM)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:DEAN
Last Name:WESTERFIELD
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13600 ICOT BLVD
Mailing Address - Street 2:BLDG B
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33760-3703
Mailing Address - Country:US
Mailing Address - Phone:888-290-6321
Mailing Address - Fax:888-875-1592
Practice Address - Street 1:13600 ICOT BLVD
Practice Address - Street 2:BLDG B
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33760-3703
Practice Address - Country:US
Practice Address - Phone:888-290-6321
Practice Address - Fax:888-875-1592
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3452213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6502SOtherBCBS
FL002726000Medicaid
FL2726000Medicaid
FL6502SOtherBCBS
FL002726000Medicaid