MEDICARE: MICHAEL A MATYAS 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	2085R0202X	Diagnostic Radiology Physician	H8241	TX
2	2085R0202X	Diagnostic Radiology Physician	MD2013-0288	NM

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	293460YLGQ	OTHER	NM	MEDICARE
3	293460YN90	OTHER	NM	MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1538162912
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL A MATYAS MD

Provider Business Mailing Address
First Line	:	8020 CONSTITUTION PL NE
Second Line	:	SUITE 202
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87110-7607
Country	:	US
Telephone Number	:	505-998-3096
Fax Number	:	505-998-3100

Provider Business Practice Location Address
First Line	:	8020 CONSTITUTION PL NE
Second Line	:	SUITE 202
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87110-7607
Country	:	US
Telephone Number	:	505-998-3096
Fax Number	:	505-998-3100

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

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	08/12/2013

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Directions to “ MICHAEL A MATYAS MD” Practice Location

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