FIDEL MATA, P.A.

Physician Assistant - Medical

Active Individual
NPI: 1558445924

Practice Address

1770 E LAKE SHORE DR STE 105
Decatur, IL 62521

Phone: (217) 422-6100

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

Nearby Providers