Provider Demographics
NPI:1760892343
Name:NEGEM, MATTHEW E (DO)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:E
Last Name:NEGEM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:MATT
Other - Middle Name:
Other - Last Name:NEGEM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:613 ELIZABETH ST STE 804
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78404-2231
Mailing Address - Country:US
Mailing Address - Phone:361-902-4343
Mailing Address - Fax:361-902-6000
Practice Address - Street 1:613 ELIZABETH ST STE 804
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-2231
Practice Address - Country:US
Practice Address - Phone:361-902-4343
Practice Address - Fax:361-902-6000
Is Sole Proprietor?:No
Enumeration Date:2014-05-05
Last Update Date:2024-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT7664207XX0801X
GA82983207XX0801X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program