MEDICARE: MATHEUS M OZBEK

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
1	152W00000X	Optometrist	9673	TX
2	152W00000X	Optometrist	3743	MN

General Provider Information

NPI Number	:	1912567876
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATHEUS M OZBEK

Provider Business Mailing Address
First Line	:	2716 LINCOLN DR
Second Line	:
City	:	ROSEVILLE
State	:	MN
Zip	:	55113-1333
Country	:	US
Telephone Number	:	651-631-9394
Fax Number	:

Provider Business Practice Location Address
First Line	:	2716 LINCOLN DR
Second Line	:
City	:	ROSEVILLE
State	:	MN
Zip	:	55113-1333
Country	:	US
Telephone Number	:	651-631-9394
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2019
Last Update Date	:	06/14/2022

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Directions to “ MATHEUS M OZBEK ” Practice Location

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