Souder, Matthew Glen

Souder, Matthew Glen is an individual health care provider with primary practice located at 100 N Academy Ave , Danville PA 17822-9800. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Souder, Matthew Glen can be contacted via phone (570) 271-6361.

Contact Information

Primary practice address
100 N Academy Ave Danville PA 17822-9800
Fax: (570) 271-5785
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X MD444252 Pennsylvania

Profile Details

NPI number 1578763215
LBN Legal business name Souder, Matthew Glen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2007
Last updated Aug 17th, 2020 - about 4 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 1578763215 NPPES
Pennsylvania MEDICAID 1027327010001
Pennsylvania Other 244821

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