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General NPI Number Information
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NPI Number | 1720370943
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Entity Type | Individual
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Provider Name | MATTHEW R SCHLOUGH M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/05/2011
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Last Update Date | 01/04/2024
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Provider Practice Location Address
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Address Line | 2211 LOMAS BLVD NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87106-2719
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Country | US
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Telephone | 505-272-1111
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Fax |
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Provider Business Mailing Address
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Address Line | 306 23RD AVE S STE 200 IORA PRIMARY CARE
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City | SEATTLE
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State | WA
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Zip | 98144-2371
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Country | US
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Telephone | 206-518-9058
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Fax |
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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 | MD60396546
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License Number State | WA
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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 | MD2019-0521
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License Number State | NM
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