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NPI Code Detail

MEDICARE: DR. GERARD A MATYSIK DO

MEDICARE: DR. GERARD A MATYSIK DO
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
1207RP1001XPulmonary Disease PhysicianOS11802FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1560910040OTHERIAMEDICARE PTAN NUMBER

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
21750367124OTHERNPI NUMBER

General Provider Information

NPI Number : 1750367124
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GERARD A MATYSIK DO
Provider Business Mailing Address
First Line : 405 MONROE ST
Second Line :
City : PELLA
State : IA
Zip : 50219-1189
Country : US
Telephone Number : 641-621-2200
Fax Number : 641-621-2335
Provider Business Practice Location Address
First Line : 405 MONROE ST
Second Line :
City : PELLA
State : IA
Zip : 50219-1189
Country : US
Telephone Number : 641-621-2200
Fax Number : 641-621-2335
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2005
Last Update Date : 08/31/2022

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Directions to “ DR. GERARD A MATYSIK DO” Practice Location

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