Provider Demographics
NPI:1306920657
Name:MATAS, ARTHUR JEREMY (MD)
Entity type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:JEREMY
Last Name:MATAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 DELAWARE ST SE
Mailing Address - Street 2:MMC 195-UNIVERSITY OF MINNESOTA PHYSICIANS
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455
Mailing Address - Country:US
Mailing Address - Phone:612-626-6100
Mailing Address - Fax:
Practice Address - Street 1:516 DELAWARE STREET SE, CLINIC 2A
Practice Address - Street 2:UNIVERSITY OF MINNESOTA PHYSICIANS
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455
Practice Address - Country:US
Practice Address - Phone:612-626-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN20886204F00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
604629OtherARAZ
17-22560OtherMEDICA CHOICE
WI31381300Medicaid
HP22189OtherHEALTH PARTNERS
1009232OtherPREFERRED ONE
OH2099910Medicaid
101556OtherUCARE
2T099MAOtherBLUE CROSS BLUE SHIELD
MN612288400Medicaid
SD7762290Medicaid
IA0977074Medicaid
ND10757Medicaid
17-00026OtherMEDICA PRIMARY
604629OtherARAZ
SD7762290Medicaid
ND10757Medicaid