Provider Demographics
NPI:1306028048
Name:REETZ, MATTHEW R (DO)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:R
Last Name:REETZ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:640 S. STATE STREET
Mailing Address - Street 2:MAIL CODE 3055
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-3530
Mailing Address - Country:US
Mailing Address - Phone:302-608-5312
Mailing Address - Fax:302-678-2552
Practice Address - Street 1:665 BAY ROAD, UNIT B
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901
Practice Address - Country:US
Practice Address - Phone:302-608-5312
Practice Address - Fax:302-678-2552
Is Sole Proprietor?:No
Enumeration Date:2007-12-05
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC2-0009857207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEC20009857OtherMEDICAL LICENSE
MDH68057OtherMEDICAL LICENSE