Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 22422 | SC |
Y | 208600000X | Surgeon | 22422 | SC |
NPI | 1023094935 |
---|---|
Provider Name | Steven A Matzinger |
First Address | Myrtle Beach, SC 29572-4614 |
Second Address | Myrtle Beach, SC 29572-4614 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2005 |
Last Update Date | 27/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
022422400 | (05) | SC |