Provencher, Matthew T
Provencher, Matthew T is an individual health care provider with primary practice located at 181 W Meadow Dr Suite 400, Vail CO 81657-5242. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Provencher, Matthew T can be contacted via phone (970) 476-1100.Contact Information
Primary practice address
181 W Meadow Dr Suite 400
Vail CO 81657-5242
Phone: (970) 476-1100
Fax: (970) 479-5835
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Sports Medicine | 207XX0005X | 255099 | Massachusetts |
| Allopathic & Osteopathic Physicians / Sports Medicine | 207XX0005X | 56291 | Colorado |
Profile Details
| NPI number | 1831162759 |
|---|---|
| LBN Legal business name | Provencher, Matthew T |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 10th, 2006 |
| Last updated | Mar 7th, 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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