Provider Demographics
NPI:1609276351
Name:KOBS, MATTHEW (MA)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:KOBS
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 KELLY ST
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03062-4508
Mailing Address - Country:US
Mailing Address - Phone:603-459-4714
Mailing Address - Fax:
Practice Address - Street 1:12 KELLY ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03062-4508
Practice Address - Country:US
Practice Address - Phone:603-459-4714
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-31
Last Update Date:2014-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program