Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 0101250178 | VA |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | D87667 | MD |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | MD048682 | DC |
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | T3788 | TX |
NPI | 1003127556 |
---|---|
Provider Name | Dr. Matthew Edward Herberg |
First Address | Fort Bliss, TX 79906-5327 |
Second Address | Fort Bliss, TX 79906-5327 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2010 |
Last Update Date | 24/12/2021 |