Spellman, Matthew J
Spellman, Matthew J is an individual health care provider with primary practice located at 12855 N 40 Dr Suite 375, Saint Louis MO 63141-8635. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Spellman, Matthew J can be contacted via phone (314) 567-6071.Contact Information
Primary practice address
12855 N 40 Dr Suite 375
Saint Louis MO 63141-8635
Phone: (314) 567-6071
Fax: (314) 567-7961
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Urology | 208800000X | 2002031745 | Missouri |
| Allopathic & Osteopathic Physicians / Urology | 208800000X | 036-108257 | Illinois |
Profile Details
| NPI number | 1205810520 |
|---|---|
| LBN Legal business name | Spellman, Matthew J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 30th, 2005 |
| Last updated | Dec 1st, 2021 - about 3 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 | 1205810520 | NPPES |
| Illinois | MEDICAID | 036108257 | |
| Illinois | MEDICAID | 209087709 |
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