Provider Demographics
NPI:1538118070
Name:MATUS, ISMAEL A (MD)
Entity Type:Individual
Prefix:DR
First Name:ISMAEL
Middle Name:A
Last Name:MATUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:200 HYGEIA DRIVE
Mailing Address - Street 2:CCHS PHYSICIAN CONTRACTING, SUITE 2300
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2049
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4745 OGLETOWN-STANTON ROAD
Practice Address - Street 2:SUITE 220
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2074
Practice Address - Country:US
Practice Address - Phone:302-623-7600
Practice Address - Fax:302-366-1240
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2016-06-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00045925207RC0200X, 207RP1001X
DEC1-0011711207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine