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NPI Code Detail

MEDICARE: MATTHEW J RADELET PA-C

MEDICARE: MATTHEW J RADELET PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AS0400XSurgical Physician Assistant4913AZ

General Provider Information

NPI Number : 1386611192
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW J RADELET PA-C
Provider Business Mailing Address
First Line : 1555 E RIVER RD
Second Line :
City : TUCSON
State : AZ
Zip : 85718-5831
Country : US
Telephone Number : 520-321-9850
Fax Number : 520-321-9005
Provider Business Practice Location Address
First Line : 1555 E RIVER RD
Second Line :
City : TUCSON
State : AZ
Zip : 85718-5831
Country : US
Telephone Number : 520-321-9850
Fax Number : 520-321-9005
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2006
Last Update Date : 11/18/2022

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Directions to “ MATTHEW J RADELET PA-C” Practice Location

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