Deboer, Matthew Ryan
Deboer, Matthew Ryan is an individual health care provider with primary practice located at 1310 County Road 210 W , Saint Johns FL 32259. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Deboer, Matthew Ryan can be contacted via phone (904) 824-4407.Contact Information
Primary practice address
1310 County Road 210 W
Saint Johns FL 32259
Phone: (904) 824-4407
Fax: (904) 390-7459
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | OS10998 | Florida |
Profile Details
| NPI number | 1104047893 |
|---|---|
| LBN Legal business name | Deboer, Matthew Ryan |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 1st, 2007 |
| Last updated | Aug 15th, 2023 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104047893 | NPPES |
| Florida | Other | P00855555 | RR MEDICARE |
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