MEDICARE: BRITTANY MATSUMURA 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	208100000X	Physical Medicine & Rehabilitation Physician	228955	NY
2	208100000X	Physical Medicine & Rehabilitation Physician	44447	CO
3	208100000X	Physical Medicine & Rehabilitation Physician	6174926-1205	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	840428757042	OTHER	RMHP
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MA44447	OTHER	BCBS

General Provider Information

NPI Number	:	1730117573
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTANY MATSUMURA MD

Provider Business Mailing Address
First Line	:	PO BOX 10100
Second Line	:
City	:	DELTA
State	:	CO
Zip	:	81416-0008
Country	:	US
Telephone Number	:	970-874-2470
Fax Number	:	970-874-2849

Provider Business Practice Location Address
First Line	:	205 STAFFORD LN
Second Line	:
City	:	DELTA
State	:	CO
Zip	:	81416-2229
Country	:	US
Telephone Number	:	970-874-2476
Fax Number	:	970-874-2849

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

Provider Enumeration Date	:	06/29/2006
Last Update Date	:	02/26/2008

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Directions to “ BRITTANY MATSUMURA MD” Practice Location

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