Provider Demographics
NPI:1467563866
Name:BITNER, MATTHEW F (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:F
Last Name:BITNER
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:990 MEDICAL DR
Mailing Address - Street 2:SUITE G5
Mailing Address - City:BRIGHAM CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84302-4713
Mailing Address - Country:US
Mailing Address - Phone:435-734-2151
Mailing Address - Fax:435-734-2192
Practice Address - Street 1:990 MEDICAL DR
Practice Address - Street 2:SUITE G5
Practice Address - City:BRIGHAM CITY
Practice Address - State:UT
Practice Address - Zip Code:84302-4713
Practice Address - Country:US
Practice Address - Phone:435-734-2151
Practice Address - Fax:435-734-2192
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT267151-1205207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID806982900Medicaid
ID1128738Medicare ID - Type Unspecified
ID806982900Medicaid