Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 01521 | MD |
N | 222Z00000X | Podiatrist | 01521 | MD |
Y | 213ES0103X | Foot & Ankle Surgery | 707 | CO |
NPI | 1003050899 |
---|---|
Provider Name | Dr. Matthew Diehl Hinderland |
First Address | Colorado Springs, CO 80920-3945 |
Second Address | Colorado Springs, CO 80920-3945 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2009 |
Last Update Date | 28/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4085040 | (05) | CO |