MATTHEW PUDERBAUGH D.O. NPI 1982959771

NPI Information

NPI: 1982959771
Provider Name: MATTHEW PUDERBAUGH, D.O.
Classification: General Practice - 208D00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
86TH MEDICAL GROUP UNIT 3215
APO, AE
ZIP 09094
Phone: (314) 479-2609
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Matthew Puderbaugh, D.O. is a general practice in Apo, AE. Matthew Puderbaugh, D.O. NPI is 1982959771. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

86TH MEDICAL GROUP UNIT 3215
APO, AE
ZIP 09094
Phone: (314) 479-2609

The NPI 1982959771 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 7/17/2012 and was last updated on 5/17/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	390200000X	Student in an Organized Health Care Education/Training Program				No
2	208D00000X	General Practice		5101019889	MICHIGAN	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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