Healthcare Provider Details

I. General information

NPI: 1790745271
Provider Name (Legal Business Name): MATTHEW E. FEIL DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2006
Last Update Date: 04/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3460 PIONEER PKWY
WEST VALLEY CITY UT
84120-2049
US

IV. Provider business mailing address

144 S 500 E 2ND FLOOR
SALT LAKE CITY UT
84102-1907
US

V. Phone/Fax

Practice location:
  • Phone: 801-964-3100
  • Fax:
Mailing address:
  • Phone: 801-463-7415
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number5858730-1204
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code207PE0005X
TaxonomyUndersea and Hyperbaric Medicine (Emergency Medicine) Physician
License Number5858730-1204
License Number StateUT
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number5858730-1204
License Number StateUT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierB002
Identifier TypeOTHER
Identifier StateUT
Identifier IssuerTRICARE
# 2
Identifier100638
Identifier TypeOTHER
Identifier StateUT
Identifier IssuerPEHP
# 3
Identifier58587031200001
Identifier TypeOTHER
Identifier StateUT
Identifier IssuerBC/BS
# 4
Identifier58587301204001
Identifier TypeOTHER
Identifier StateUT
Identifier IssuerBC/BS
# 5
Identifier58587301202001
Identifier TypeOTHER
Identifier StateUT
Identifier IssuerBC/BS
# 6
IdentifierP00252694
Identifier TypeOTHER
Identifier StateUT
Identifier IssuerRAILROAD MEDICARE
# 7
Identifier58587301205001
Identifier TypeOTHER
Identifier StateUT
Identifier IssuerBC/BS
# 8
Identifier58587301206001
Identifier TypeOTHER
Identifier StateUT
Identifier IssuerBC/BS
# 9
Identifier58587301201001
Identifier TypeOTHER
Identifier StateUT
Identifier IssuerBC/BS
# 10
Identifier58587301203001
Identifier TypeOTHER
Identifier StateUT
Identifier IssuerBC/BS
# 11
IdentifierD6098
Identifier TypeMEDICAID
Identifier StateUT
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: