Provider Demographics
NPI:1194895367
Name:MATEER, DAVID E (RPH)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:E
Last Name:MATEER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:SALTSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15681-1131
Mailing Address - Country:US
Mailing Address - Phone:724-639-9022
Mailing Address - Fax:724-639-3535
Practice Address - Street 1:237 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:SALTSBURG
Practice Address - State:PA
Practice Address - Zip Code:15681-1131
Practice Address - Country:US
Practice Address - Phone:724-639-9022
Practice Address - Fax:724-639-3535
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP025266L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP025266LOtherSTATE LICENSE