Matwijiw, Igor Evan

Matwijiw, Igor Evan is an individual health care provider with primary practice located at 2602 Saint Michael Dr Ste 201B , Texarkana TX 75503-2320. He recently has only one registered license in Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism, which is considered as his primary health care specialty. Matwijiw, Igor Evan can be contacted via phone (903) 614-5530.

Contact Information

Primary practice address
2602 Saint Michael Dr Ste 201B Texarkana TX 75503-2320
Phone: (903) 614-5530
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism 207RE0101X J4910 Texas

Profile Details

NPI number 1114911369
LBN Legal business name Matwijiw, Igor Evan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 2nd, 2005
Last updated Jun 22nd, 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 1114911369 NPPES
Oklahoma MEDICAID 200298690A
Oklahoma MEDICAID 126488902
Oklahoma Other 460002032
Oklahoma MEDICAID 126488906
Oklahoma Other 4321815
Oklahoma Other 87592Z
Oklahoma Other 87281J

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