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1700871175

NPI Code Detail

MEDICARE: MATTHEW S DIKIN DO

MEDICARE: MATTHEW S DIKIN DO

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	207P00000X	Emergency Medicine Physician	DO2227	NV
2	207P00000X	Emergency Medicine Physician	5101013187	MI
3	207R00000X	Internal Medicine Physician	5101013187	MI
4	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	DO2227	NV
5	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	008768	AZ
6	207R00000X	Internal Medicine Physician	DO2227	NV

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00202614	OTHER	MI	RAILROAD MEDICARE

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
2	MD013187	OTHER		BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1700871175
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW S DIKIN DO

Provider Business Mailing Address
First Line	:	850 HARVARD WAY
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89502-2055
Country	:	US
Telephone Number	:	775-982-5262
Fax Number	:	775-982-5496

Provider Business Practice Location Address
First Line	:	1955 W FRYE RD
Second Line	:
City	:	CHANDLER
State	:	AZ
Zip	:	85224-6282
Country	:	US
Telephone Number	:	480-728-3000
Fax Number	:	602-230-6461

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

Provider Enumeration Date	:	09/13/2005
Last Update Date	:	12/17/2021

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Directions to “ MATTHEW S DIKIN DO” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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