MEDICARE: CAROLYN ANNE MATZINGER M.D.

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	207R00000X	Internal Medicine Physician	10187	NV
2	208M00000X	Hospitalist Physician	M-10201	ID
3	207R00000X	Internal Medicine Physician	M-10201	ID

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447252911
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLYN ANNE MATZINGER M.D.

Provider Business Mailing Address
First Line	:	10620 SOUTHERN HIGHLANDS PKWY
Second Line	:	SUITE 110-419
City	:	LAS VEGAS
State	:	NV
Zip	:	89141-4371
Country	:	US
Telephone Number	:	702-380-1974
Fax Number	:	702-269-5547

Provider Business Practice Location Address
First Line	:	10620 SOUTHERN HIGHLANDS PKWY
Second Line	:	SUITE 110-419
City	:	LAS VEGAS
State	:	NV
Zip	:	89141-4371
Country	:	US
Telephone Number	:	702-380-1974
Fax Number	:	702-269-5547

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

Provider Enumeration Date	:	08/12/2005
Last Update Date	:	01/11/2013

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