Provider Demographics
NPI:1205816709
Name:MATEIK, WILLIAM JOSEPH (OD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JOSEPH
Last Name:MATEIK
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:WINCHENDON
Mailing Address - State:MA
Mailing Address - Zip Code:01475-1626
Mailing Address - Country:US
Mailing Address - Phone:978-297-2020
Mailing Address - Fax:978-297-0486
Practice Address - Street 1:13 WALNUT ST
Practice Address - Street 2:
Practice Address - City:WINCHENDON
Practice Address - State:MA
Practice Address - Zip Code:01475-1626
Practice Address - Country:US
Practice Address - Phone:978-297-2020
Practice Address - Fax:978-297-0486
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-19
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2292152W00000X, 152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0310379Medicaid
MA41238OtherFALLON COMMUNITY HEALTH
MA15655OtherHARVARD PILGRIM
MAW20137OtherBLUE CROSS BLUE SHIELD
MA23568OtherCIGNA
MA722509OtherTUFTS
MA23568OtherCIGNA
MAMA120858Medicare ID - Type Unspecified
MAT 59127Medicare UPIN