Healthcare Provider Details

I. General information

NPI: 1568450666
Provider Name (Legal Business Name): MATTHEW E KARLOVSKY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2005
Last Update Date: 10/02/2024
Certification Date: 10/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2530 E SOUTHERN AVE
MESA AZ
85204-5411
US

IV. Provider business mailing address

25 CROSSROADS DR STE 306
OWINGS MILLS MD
21117-5437
US

V. Phone/Fax

Practice location:
  • Phone: 480-834-4188
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number33566
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code2088F0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Urology) Physician
License Number33566
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number33566
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: