Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 45678 | AZ |
N | 207RA0201X | Internist - Allergy & Immunology | 49008 | MN |
NPI | 1174530414 |
---|---|
Provider Name | Matthew A Rank |
First Address | Scottsdale, AZ 85259-5452 |
Second Address | Scottsdale, AZ 85259-5452 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 03/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
634443000 | (05) | MN |
709261 | (05) | AZ |
I58777 | (02) | |
P00629162 | RAILROAD MEDICARE (01) | MN |