MEDICARE: MATTHEW MERLE WETZEL MD

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
1	207T00000X	Neurological Surgery Physician	MD425095	PA

General Provider Information

NPI Number	:	1104852946
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW MERLE WETZEL MD

Provider Business Mailing Address
First Line	:	425 FRYE FARM RD
Second Line	:
City	:	GREENSBURG
State	:	PA
Zip	:	15601-6480
Country	:	US
Telephone Number	:	724-532-0866
Fax Number	:	724-532-0869

Provider Business Practice Location Address
First Line	:	425 FRYE FARM RD
Second Line	:
City	:	GREENSBURG
State	:	PA
Zip	:	15601-6480
Country	:	US
Telephone Number	:	724-532-0866
Fax Number	:	724-532-0869

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2006
Last Update Date	:	01/02/2015

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