Matheson, Evan J

Matheson, Evan J is an sole proprietor health care provider with primary practice located at 745 N 500 W #200, Provo UT 84601-1472. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Allergy & Immunology. Allopathic & Osteopathic Physicians / Allergy & Immunology is his primary health care specialty. Matheson, Evan J can be contacted via phone (801) 375-9292.

Contact Information

Primary practice address
745 N 500 W #200 Provo UT 84601-1472
Phone: (801) 375-9292
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 1758051205 Utah
Allopathic & Osteopathic Physicians / Allergy & Immunology 207K00000X 1758051205 Utah

Profile Details

NPI number 1649251646
LBN Legal business name Matheson, Evan J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 8th, 2005
Last updated Apr 18th, 2019 - about 5 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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Identifiers

StateTypeNumberIssuer
All States NPI 1649251646 NPPES
Utah Other 841428839 ALTIUS
Utah Other 0200019 ALTIUS
Utah Other 107007559101 ALTIUS

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