Provider Demographics
NPI:1609451988
Name:MATYAS, MAIA (PA-C)
Entity Type:Individual
Prefix:
First Name:MAIA
Middle Name:
Last Name:MATYAS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 638269
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-8269
Mailing Address - Country:US
Mailing Address - Phone:440-816-2878
Mailing Address - Fax:
Practice Address - Street 1:10139 ROYALTON RD STE H
Practice Address - Street 2:
Practice Address - City:NORTH ROYALTON
Practice Address - State:OH
Practice Address - Zip Code:44133-4473
Practice Address - Country:US
Practice Address - Phone:440-816-2878
Practice Address - Fax:216-524-7933
Is Sole Proprietor?:No
Enumeration Date:2021-03-17
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.006914RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant