Provider Demographics
NPI:1437448453
Name:PARKER, MATTHEW GERARD (MD)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:GERARD
Last Name:PARKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9610 N METRO PKWY W
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85051-1402
Mailing Address - Country:US
Mailing Address - Phone:623-583-3001
Mailing Address - Fax:480-491-6239
Practice Address - Street 1:9610 N METRO PKWY W
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85051-1402
Practice Address - Country:US
Practice Address - Phone:623-583-3001
Practice Address - Fax:602-843-1560
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-30
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ50762207Q00000X
WAMD60394712207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine