Provider Demographics
NPI:1366422727
Name:DEORIO, MATTHEW J (MD)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:J
Last Name:DEORIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:927 FRANKLIN ST SE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4306
Mailing Address - Country:US
Mailing Address - Phone:256-539-2728
Mailing Address - Fax:256-539-2666
Practice Address - Street 1:927 FRANKLIN ST SE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4306
Practice Address - Country:US
Practice Address - Phone:256-539-2728
Practice Address - Fax:256-539-2666
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL28782207X00000X, 207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL7881949OtherAETNA
AL51042058OtherBCBS
AL51040155OtherBCBS
ALZ01267OtherVIVA HEALTHCARE
ALP00030620OtherRAILROAD MEDICARE
AL09-01497OtherUNITED HEALTHCARE
AL000102657Medicaid
AL000102657Medicaid
AL51042058OtherBCBS
AL510I200047Medicare PIN