Provider Demographics
NPI:1104321595
Name:DILIZIA, E MATTHEW (MD)
Entity type:Individual
Prefix:
First Name:E
Middle Name:MATTHEW
Last Name:DILIZIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1518 E 3RD ST STE 250
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-3192
Mailing Address - Country:US
Mailing Address - Phone:704-248-3400
Mailing Address - Fax:704-337-8387
Practice Address - Street 1:10660 PARK RD STE 4100
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-8551
Practice Address - Country:US
Practice Address - Phone:704-541-8207
Practice Address - Fax:704-540-8288
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-27
Last Update Date:2023-06-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC202300314208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty