Boughton, Mateo
Boughton, Mateo is an sole proprietor health care provider with primary practice located at 237 26Th St , Ogden UT 84401-3105. He recently has only one registered license in Other Service Providers / Community Health Worker, which is considered as his primary health care specialty. Boughton, Mateo can be contacted via phone (801) 625-3700.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Community Health Worker | 172V00000X |
Profile Details
| NPI number | 1356112098 |
|---|---|
| LBN Legal business name | Boughton, Mateo |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 11th, 2024 |
| Last updated | Jan 11th, 2024 - about 11 months 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1356112098 | NPPES |
| Utah | Other | 000055266 | MEDICARE PIN |
| Utah | Other | 260022408 | MEDICARE PIN |
| Utah | MEDICAID | 8760003008007 | MEDICARE PIN |
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