Provider Demographics
NPI:1851382097
Name:DRAGHETTI, MATTHEW JAMES (MD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:JAMES
Last Name:DRAGHETTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 DREYER WAY
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03867-2775
Mailing Address - Country:US
Mailing Address - Phone:603-332-6413
Mailing Address - Fax:603-335-1076
Practice Address - Street 1:7 DREYER WAY
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03867-2775
Practice Address - Country:US
Practice Address - Phone:603-332-6413
Practice Address - Fax:603-335-1076
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME0155532085R0202X
NH134242085R0202X
NC2022-020922085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME041192OtherBLUE SHIELD
MEE000134OtherCHAMPUS
NH01Y003317ME03OtherANTHEM
ME300120402OtherRR MEDICARE
NH01Y003317ME01OtherBLUE SHIELD OF NH
MEH39828OtherHARVARD
MEM202991OtherCIGNA
ME273900099Medicaid
NH30201915Medicaid
NH56117OtherNH HEALTHSOURCE
NH01Y003317ME03OtherANTHEM