Provider Demographics
NPI:1184085169
Name:DR MATTHIAS PC
Entity type:Organization
Organization Name:DR MATTHIAS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:F
Authorized Official - Last Name:MATTHIAS
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:919-628-0077
Mailing Address - Street 1:7900 E PRINCESS DR
Mailing Address - Street 2:UNIT 2163
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-5806
Mailing Address - Country:US
Mailing Address - Phone:919-628-0077
Mailing Address - Fax:
Practice Address - Street 1:9312 E RAINTREE DR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2094
Practice Address - Country:US
Practice Address - Phone:480-779-7755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-17
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ16-1532175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty