Provider Demographics
NPI:1932132883
Name:SYMKOWICK, MATTTHEW SCHROEDER (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTTHEW
Middle Name:SCHROEDER
Last Name:SYMKOWICK
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 1:229 SUNNYSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94611-4455
Mailing Address - Country:US
Mailing Address - Phone:510-428-1948
Mailing Address - Fax:707-651-2743
Practice Address - Street 1:975 SERENO DR
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94589-2441
Practice Address - Country:US
Practice Address - Phone:707-651-4936
Practice Address - Fax:707-651-2743
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0062489207Q00000X
DCMD034950207Q00000X
CAA78791207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCI30826Medicare UPIN
DC017210P71Medicare ID - Type Unspecified