Bertus, Matthew S
Bertus, Matthew S is an individual health care provider with primary practice located at 4050 W Memorial Rd Third Floor, Oklahoma City OK 73120-8382. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is his primary health care specialty. Bertus, Matthew S can be contacted via phone (405) 608-3800.Contact Information
Primary practice address
4050 W Memorial Rd Third Floor
Oklahoma City OK 73120-8382
Phone: (405) 608-3800
Fax: (405) 608-3838
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 861 | Oklahoma |
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 861 | Oklahoma |
Profile Details
| NPI number | 1093706368 |
|---|---|
| LBN Legal business name | Bertus, Matthew S |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 4th, 2005 |
| Last updated | Feb 17th, 2011 - about 14 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 | 1093706368 | NPPES |
| Oklahoma | MEDICAID | 10011900A |
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