Divietro, Matthew L

Divietro, Matthew L is an individual health care provider with primary practice located at 2347 E Gala St , Meridian ID 83642-4881. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Pulmonary Disease is his primary health care specialty. Divietro, Matthew L can be contacted via phone (208) 323-3767.

Contact Information

Primary practice address
2347 E Gala St Meridian ID 83642-4881
Phone: (208) 323-3767
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X O 0727 Idaho
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X O 0727 Idaho
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X O 0727 Idaho

Profile Details

NPI number 1427265867
LBN Legal business name Divietro, Matthew L
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date May 16th, 2007
Last updated Aug 24th, 2022 - about 3 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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