Healthcare Provider Details

I. General information

NPI: 1134318942
Provider Name (Legal Business Name): MATTHEW M TROESTER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2007
Last Update Date: 03/27/2023
Certification Date: 03/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8952 E DESERT COVE AVE STE E206
SCOTTSDALE AZ
85260-6775
US

IV. Provider business mailing address

10645 N TATUM BLVD STE 200-128
PHOENIX AZ
85028-3068
US

V. Phone/Fax

Practice location:
  • Phone: 480-280-0078
  • Fax: 833-921-2188
Mailing address:
  • Phone: 480-280-0078
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License Number4037
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number4037
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number4037
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: