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General NPI Number Information
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NPI Number | 1770591562
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Entity Type | Individual
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Provider Name | JOHN HENRY MATSUURA MD
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Gender | Male
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 2300 MIAMI VALLEY DR STE 350
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City | DAYTON
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State | OH
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Zip | 45459-1294
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Country | US
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Telephone | 937-424-2469
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Fax | 937-424-2479
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Provider Business Mailing Address
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Address Line | 2300 MIAMI VALLEY DR STE 350
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City | CENTERVILLE
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State | OH
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Zip | 45459-1294
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Country | US
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Telephone | 937-438-8640
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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 | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 37403
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | MD-20852
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License Number State | HI
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Taxonomy #3
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 35.0575510
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License Number State | OH
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