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NPI Code Detail

MEDICARE: DAWN MARIE MATUSZ MS, NDTR

MEDICARE:   DAWN MARIE MATUSZ  MS, NDTR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1136A00000XRegistered Dietetic Technician

General Provider Information

NPI Number : 1083296198
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAWN MARIE MATUSZ MS, NDTR
Provider Business Mailing Address
First Line : 4236 CLAYMONT ST APT 1
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-6810
Country : US
Telephone Number : 702-244-0078
Fax Number :
Provider Business Practice Location Address
First Line : 4236 CLAYMONT ST APT 1
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-6810
Country : US
Telephone Number : 702-244-0078
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2021
Last Update Date : 04/27/2021

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Directions to “ DAWN MARIE MATUSZ MS, NDTR” Practice Location

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