Matthew R Sericati, M.D. Chartered

LBN: Matthew R Sericati, M.D. Chartered
Matthew R Sericati, M.D. Chartered is an health care organization with primary practice located at 425 W Bannock St , Boise ID 83702-6035. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as the primary health care specialty. Matthew R Sericati, M.D. Chartered can be contacted via phone (208) 343-1702, or through Sericati, Matthew R via phone (208) 343-1702.

Contact Information

Primary practice address
425 W Bannock St Boise ID 83702-6035
Phone: (208) 343-1702
Fax: (208) 342-7042
Website:
Map and Directions
Authorized official contact:
Name: Sericati, Matthew R Doctor of Medicine (MD)
Phone: (208) 343-1702

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X M10669 Idaho

Profile Details

NPI number 1760774483
LBN Legal business name Matthew R Sericati, M.D. Chartered
DBA Doing business as
Authorized official Sericati, Matthew R Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date May 13th, 2011
Last updated Jul 19th, 2019 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760774483 NPPES
Other 1194871871 INDIVIDUAL NPI

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