Provider Demographics
NPI:1619276979
Name:BIHLMAIER, MATTHEW (DO/MBA)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:BIHLMAIER
Suffix:
Gender:M
Credentials:DO/MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 MAINE ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-1361
Mailing Address - Country:US
Mailing Address - Phone:785-505-5635
Mailing Address - Fax:785-505-5306
Practice Address - Street 1:404 MAINE ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044
Practice Address - Country:US
Practice Address - Phone:785-505-5635
Practice Address - Fax:785-505-5306
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-24
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
KS05-38177207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program