Matos, Luis Angel

Matos, Luis Angel is an individual health care provider with primary practice located at 1019A Vista Park Dr , Forest VA 24551-4901. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Allergy/Immunology, Allopathic & Osteopathic Physicians / Allergy. Allopathic & Osteopathic Physicians / Allergy is his primary health care specialty. Matos, Luis Angel can be contacted via phone (434) 515-0419.

Contact Information

Primary practice address
1019A Vista Park Dr Forest VA 24551-4901
Phone: (434) 515-0419
Fax: (844) 693-9305
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 0101056392 Virginia
Allopathic & Osteopathic Physicians / Pediatric Allergy/Immunology 2080P0201X 0101056392 Virginia
Allopathic & Osteopathic Physicians / Allergy 207KA0200X 0101056392 Virginia

Profile Details

NPI number 1972506509
LBN Legal business name Matos, Luis Angel
Credentials M.D., MBA
Entity Individual
Sole proprietor 1 No
Enumeration date May 27th, 2005
Last updated Apr 10th, 2018 - about 7 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 1972506509 NPPES
Virginia MEDICAID 5804426

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