Demattei, Clay O.

Demattei, Clay O. is an individual health care provider with primary practice located at 3402 Office Park Dr. , Marion IL 62959. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Demattei, Clay O. can be contacted via phone (618) 993-3221.

Contact Information

Primary practice address
3402 Office Park Dr. Marion IL 62959
Phone: (618) 993-3221
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 036072552 Illinois

Profile Details

NPI number 1881621910
LBN Legal business name Demattei, Clay O.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 26th, 2006
Last updated Jan 5th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881621910 NPPES
Illinois Other 036072552 STATE LICENSE NUMBER
Illinois MEDICAID 036072552 STATE LICENSE NUMBER

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