Provider Demographics
NPI:1730475351
Name:PETERSON, MATTHEW ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:ROBERT
Last Name:PETERSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1195 GARNER FIELD RD STE 200
Mailing Address - Street 2:
Mailing Address - City:UVALDE
Mailing Address - State:TX
Mailing Address - Zip Code:78801-4822
Mailing Address - Country:US
Mailing Address - Phone:830-278-6200
Mailing Address - Fax:830-278-3359
Practice Address - Street 1:1195 GARNER FIELD RD STE 200
Practice Address - Street 2:
Practice Address - City:UVALDE
Practice Address - State:TX
Practice Address - Zip Code:78801-4822
Practice Address - Country:US
Practice Address - Phone:830-278-6200
Practice Address - Fax:830-278-3359
Is Sole Proprietor?:No
Enumeration Date:2011-06-22
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE26907207R00000X
TXR3941207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine