Provider Demographics
NPI:1467540450
Name:MATSUSHITA, CINDY M (MD)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:M
Last Name:MATSUSHITA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:M
Other - Last Name:MATSUSHITA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3450 ZAFARANO DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87507-2669
Mailing Address - Country:US
Mailing Address - Phone:505-466-5885
Mailing Address - Fax:505-466-5886
Practice Address - Street 1:3450 ZAFARANO DR
Practice Address - Street 2:SUITE C
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87507-2669
Practice Address - Country:US
Practice Address - Phone:505-466-5885
Practice Address - Fax:505-466-5886
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2017-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC25703207Q00000X
NMMD2009-0498207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine