Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208800000X | Urologist | 2007007773 | MO |
Y | 208800000X | Urologist | E6011 | AR |
NPI | 1033258074 |
---|---|
Provider Name | Dr. Matthew D Katz |
First Address | Brunswick, GA 31520 |
Second Address | Brunswick, GA 31520 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2007 |
Last Update Date | 07/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
180091001 | (05) | AR |
207306101 | (05) | MO |
I73604 | (02) |