Provider Demographics
NPI:1235155862
Name:OREM, MATTHEW T (DC)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:T
Last Name:OREM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 368
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-0368
Mailing Address - Country:US
Mailing Address - Phone:740-363-4500
Mailing Address - Fax:866-438-7821
Practice Address - Street 1:20 TROY RD
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-4501
Practice Address - Country:US
Practice Address - Phone:740-363-2311
Practice Address - Fax:866-438-7821
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2011-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2501111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2044602Medicaid
OH0850081Medicare PIN
OHU71257Medicare UPIN