Provider Demographics
NPI:1194384008
Name:HARTNETT, MATTHEW JOSPEH (MD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:JOSPEH
Last Name:HARTNETT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 424
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50302-0424
Mailing Address - Country:US
Mailing Address - Phone:515-875-9925
Mailing Address - Fax:515-875-9923
Practice Address - Street 1:1215 PLEASANT ST STE 206
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1419
Practice Address - Country:US
Practice Address - Phone:515-875-9092
Practice Address - Fax:515-875-9828
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-13
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-49604207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine