Provider Demographics
NPI:1336299932
Name:VAIL, MATTHEW A (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:A
Last Name:VAIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3545 OLENTANGY RIVER RD
Mailing Address - Street 2:SUITE 425
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-3907
Mailing Address - Country:US
Mailing Address - Phone:614-566-5335
Mailing Address - Fax:614-566-6931
Practice Address - Street 1:3545 OLENTANGY RIVER RD
Practice Address - Street 2:SUITE 425
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3907
Practice Address - Country:US
Practice Address - Phone:614-566-5335
Practice Address - Fax:614-566-6931
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH786512083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine