Matthew A Ketelaar in Davenport - Diagnostic Radiology
Matthew A Ketelaar - NPI 1336109180
Matthew A Ketelaar is a Diagnostic Radiology in Davenport, Iowa. Matthew A Ketelaar practices all healthcare services and medical treatments related to Diagnostic Radiology. The NPI Number for Matthew A Ketelaar is 1336109180. The last update date is 2021-05-05.
Matthew A Ketelaar's current location address is 1970 E 53rd St, Davenport, Iowa. You can contact this provider via phone number 5633593949. The mailing address for Matthew A Ketelaar is 1970 E 53rd St, Davenport, Iowa. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Matthew A Ketelaar |
|---|---|
| Address | 1970 E 53rd St, Davenport, Iowa |
| Phone Number | 5633593949 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1336109180 |
|---|---|
| Provider Enumeration Date | 2006-03-24 |
| Last Updated Date | 2021-05-05 |
Provider Mailing Address Detail
| Address | 1970 E 53rd St |
|---|---|
| City | Davenport |
| State | Iowa (IA) |
| Post Code | 528072710 |
| Phone Number | 5633593949 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Diagnostic Radiology |
|---|---|
| Taxonomy | 2085R0202X |
| Licence No | 28007 |
|
Definition: A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 300034141 | RR MDC RGPCSC | ||
| 5096792 | IA | -- | |
| 2096792 | IA | -- | |
| 300132302 | RR MDC RGIC LLC | ||
| 32281 | BCBS IA RGPCSC | ||
| 6050 | BCBS IA RGIC LLC |
Post Comment/ Review Below
What is the unique provider identifier assigned to Matthew A Ketelaar?
The Matthew A Ketelaar has been issued the NPI (National Provider Identifier) 1336109180 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please share the complete physical address where Matthew A Ketelaar is geographically located?
The Matthew A Ketelaar is physically situated at the following location: 1970 E 53Rd St, Davenport, IA, 528072710.
What is the area of specialization for Matthew A Ketelaar, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Matthew A Ketelaar is Diagnostic Radiology, and the corresponding taxonomy code that categorizes this area of expertise is 2085R0202X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1336109180 to Matthew A Ketelaar?
The Centers for Medicare & Medicaid Services originally issued the 1336109180 to Matthew A Ketelaar on 2006-03-24.
As of what date were the details related to Matthew A Ketelaar most recently updated or revised?
The information pertaining to Matthew A Ketelaar, including its address, specialty, and other relevant details, was last updated or revised on 2021-05-05.