Dr. Matthew Aaron Burtelow, M.D.
Pathology, Anatomic Pathology & Clinical Pathology in Boise, ID. Individual provider (NPI-1).
NPI number1760670285
StatusActive
Last updated in NPPESJul 29, 2009
Details
- NPI
- 1760670285
- Entity type
- Individual (NPI-1)
- Name
- Dr. Matthew Aaron Burtelow
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 10, 2007
- Last updated
- Jul 29, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207ZP0102X | Pathology, Anatomic Pathology & Clinical Pathology | 60022117 | WA | Yes |
| 207ZC0006X | Pathology, Clinical Pathology | A88725 | CA | |
| 207ZP0101X | Pathology, Anatomic Pathology | A88725 | CA |
Practice location
190 E Bannock StBoise, ID 83712-6241
Phone 208-381-2367 · Fax 208-381-4762
Mailing address
190 E Bannock StBoise, ID 83712-6241
Phone 208-381-2367 · Fax 208-381-4762
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