Pouliot, Matthew David

Pouliot, Matthew David is an individual health care provider with primary practice located at 3744 S Timberline Rd Suite 102, Fort Collins CO 80525-4333. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pain Medicine, which is considered as his primary health care specialty. Pouliot, Matthew David can be contacted via phone (970) 495-0506.

Contact Information

Primary practice address
3744 S Timberline Rd Suite 102 Fort Collins CO 80525-4333
Phone: (970) 495-0506
Fax: (970) 495-0485
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pain Medicine 208VP0000X DR.0048088 Colorado
Allopathic & Osteopathic Physicians / Pain Medicine 2081P2900X 48088 Colorado

Profile Details

NPI number 1154584266
LBN Legal business name Pouliot, Matthew David
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 8th, 2008
Last updated Aug 26th, 2016 - about 9 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154584266 NPPES
Wyoming MEDICAID 132413600
Wyoming MEDICAID 10026360700
Wyoming MEDICAID 53107578

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