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General NPI Number Information
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NPI Number | 1396039590
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Entity Type | Individual
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Provider Name | MATTHEW STEPHEN GIORDANENGO D.O.
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Gender | Male
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Dates
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Enumeration Date | 06/06/2011
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 384 SE COMBS FLAT RD STE 1200
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City | PRINEVILLE
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State | OR
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Zip | 97754-2562
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Country | US
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Telephone | 541-447-6263
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Fax | 541-447-8724
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Provider Business Mailing Address
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Address Line | 123 S 27TH ST
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City | BILLINGS
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State | MT
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Zip | 59101-4227
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Country | US
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Telephone | 406-247-3350
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Fax | 406-247-3389
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 33915
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OT014134
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DO221066
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License Number State | OR
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