Matich, Andrea Jensen

Matich, Andrea Jensen is an sole proprietor health care provider with primary practice located at 96 E Kimballs Ln Ste 207 , Draper UT 84020-5021. She recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as her primary health care specialty. Matich, Andrea Jensen can be contacted via phone (801) 576-2300.

Contact Information

Primary practice address
96 E Kimballs Ln Ste 207 Draper UT 84020-5021
Phone: (801) 576-2300
Fax: (844) 249-1746
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 6354383-1205 Utah

Profile Details

NPI number 1902092133
LBN Legal business name Matich, Andrea Jensen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 21st, 2007
Last updated Jan 20th, 2020 - 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 1902092133 NPPES
Utah MEDICAID 1265638357

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