Provider Demographics
NPI:1891821476
Name:MATYAS, BELA T (MD)
Entity Type:Individual
Prefix:
First Name:BELA
Middle Name:T
Last Name:MATYAS
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 1:380A GREAT RD
Mailing Address - Street 2:#303
Mailing Address - City:ACTON
Mailing Address - State:MA
Mailing Address - Zip Code:01720-4058
Mailing Address - Country:US
Mailing Address - Phone:617-983-6847
Mailing Address - Fax:
Practice Address - Street 1:MASS DEPT OF PUBLIC HLTH
Practice Address - Street 2:305 SOUTH ST
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130
Practice Address - Country:US
Practice Address - Phone:617-983-6847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA566912083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine