Provider Demographics
NPI:1962681171
Name:UBEDEI, MATTHEW SABO (OD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:SABO
Last Name:UBEDEI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:5955 ZEAMER AVENUE
Mailing Address - Street 2:673 MDG
Mailing Address - City:JBER
Mailing Address - State:AK
Mailing Address - Zip Code:99506
Mailing Address - Country:US
Mailing Address - Phone:907-580-1035
Mailing Address - Fax:907-580-3203
Practice Address - Street 1:5955 ZEAMER AVENUE
Practice Address - Street 2:673 MDG
Practice Address - City:JBER
Practice Address - State:AK
Practice Address - Zip Code:99506
Practice Address - Country:US
Practice Address - Phone:907-580-1035
Practice Address - Fax:907-580-3203
Is Sole Proprietor?:No
Enumeration Date:2007-10-24
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7105T152W00000X
AK329152W00000X
WAOD00004141152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist