Bak, Matthew J
Bak, Matthew J is an individual health care provider with primary practice located at 600 Gresham Dr Suite 1100, Norfolk VA 23507-1904. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic Surgery within the Head & Neck, which is considered as his primary health care specialty. Bak, Matthew J can be contacted via phone (757) 388-6200.Contact Information
Primary practice address
600 Gresham Dr Suite 1100
Norfolk VA 23507-1904
Phone: (757) 388-6200
Fax: (757) 388-6201
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Plastic Surgery within the Head & Neck | 207YX0007X | 0101245661 | Virginia |
Profile Details
| NPI number | 1659386076 |
|---|---|
| LBN Legal business name | Bak, Matthew J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 31st, 2006 |
| Last updated | Jan 28th, 2015 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659386076 | NPPES |
| Virginia | Other | -004 | TRICARE/CHAMPUS |
| Virginia | Other | PAR | TRICARE/CHAMPUS |
| Virginia | Other | PAR | TRICARE/CHAMPUS |
| Virginia | Other | 373343 | TRICARE/CHAMPUS |
| Virginia | Other | PAR | TRICARE/CHAMPUS |
| Virginia | Other | PAR | TRICARE/CHAMPUS |
| Virginia | Other | 10047408 | TRICARE/CHAMPUS |
| Virginia | MEDICAID | 1659386076 | TRICARE/CHAMPUS |
| Virginia | Other | PAR | TRICARE/CHAMPUS |
| Virginia | Other | PAR | TRICARE/CHAMPUS |
| Virginia | Other | PAR | TRICARE/CHAMPUS |
| Virginia | Other | 11764 | TRICARE/CHAMPUS |
| Virginia | Other | PAR | TRICARE/CHAMPUS |
| Virginia | Other | 373342 | TRICARE/CHAMPUS |
| Virginia | Other | PAR | TRICARE/CHAMPUS |
| Virginia | MEDICAID | 5911764 | TRICARE/CHAMPUS |
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