Provider Demographics
NPI:1700171675
Name:FERRONI, MATTHEW C (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:C
Last Name:FERRONI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:MERCY UROLOGY CLINIC
Mailing Address - Street 2:701 10TH STREET SE
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52401
Mailing Address - Country:US
Mailing Address - Phone:319-398-6865
Mailing Address - Fax:319-398-6635
Practice Address - Street 1:MERCY UROLOGY CLINIC
Practice Address - Street 2:701 10TH STREET SE
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52401
Practice Address - Country:US
Practice Address - Phone:319-398-6865
Practice Address - Fax:319-398-6635
Is Sole Proprietor?:No
Enumeration Date:2011-06-18
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI69106208800000X
IAMD-48990208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMT200097OtherMEDICAL LICENSE