FIDEL MATA, P.A.
Physician Assistant - Medical
Active
Individual
NPI: 1558445924
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Internal Medicine - Cardiovascular Disease | 207RC0000X | No | 085.002235 (IL) |
| Physician Assistant - Medical | 363AM0700X | Yes | 085-002235 (IL) |
Frequently Asked Questions
NPI 1558445924 is the National Provider Identifier for FIDEL MATA, P.A., a Physician Assistant - Medical provider located in Decatur, IL. This NPI was enumerated on October 24, 2006.
FIDEL MATA, P.A. practices at 1770 E LAKE SHORE DR STE 105, Decatur, IL 62521.
Quick Facts
- NPI
- 1558445924
- Type
- Individual
- Enumerated
- Oct 24, 2006
- Last Updated
- Dec 20, 2021
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