NPI 1194268458

Derek William Matthies

Practitioner Student in an Organized Health Care Education/Training Program Apo, AP

Practice location

Address: 2200 Bergquist Drive, Suite 1 Attn: Credentials (sghc) Jbsa-Lackland, Apo, AP 78236-9908
Phone: (714) 904-4463
Mailing address: 11622 Hunter Ivy, San Antonio, TX 78253-5866

Registered specialties

Student in an Organized Health Care Education/Training Program Primary

Student, Health Care Taxonomy 390200000X

Other Student in an Organized Health Care Education/Training Program providers in Armed Forces Pacific →

Registry record

NPI: 1194268458
Entity type: Individual
Sex (as registered): Male
NPI issued: 18 Nov 2016
Record last updated: 26 Jan 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.