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NPI Code Detail

MEDICARE: MR. MATEAUR PEERY

MEDICARE: MR. MATEAUR PEERY
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
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1780194365
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MATEAUR PEERY
Provider Business Mailing Address
First Line : 235 TORRINGTON DR
Second Line :
City : TOLEDO
State : OH
Zip : 43615-5442
Country : US
Telephone Number : 419-704-0756
Fax Number :
Provider Business Practice Location Address
First Line : 3518 MONROE ST
Second Line :
City : TOLEDO
State : OH
Zip : 43606-4114
Country : US
Telephone Number : 419-241-2182
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/09/2017
Last Update Date : 10/09/2017

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Directions to “ MR. MATEAUR PEERY ” Practice Location

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