Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 67343 | WI |
N | 111NI0900X | Internist | 67343 | WI |
N | 207RC0000X | Internist - Cardiovascular Disease | DR.0065978 | CO |
Y | 207RI0011X | Interventional Cardiology | DR.0065978 | CO |
NPI | 1003234162 |
---|---|
Provider Name | Matthew M Mcdiarmid |
First Address | Thornton, CO 80023-9210 |
Second Address | Thornton, CO 80023-9210 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2014 |
Last Update Date | 23/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100080074 | (05) | WI |