Provider Demographics
NPI:1205099538
Name:KREBS, MATTHEW JUSTIN (MD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:JUSTIN
Last Name:KREBS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 N 3RD ST
Mailing Address - Street 2:THIRD FLOOR
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17110-1904
Mailing Address - Country:US
Mailing Address - Phone:717-782-6829
Mailing Address - Fax:717-782-6831
Practice Address - Street 1:2501 N 3RD ST
Practice Address - Street 2:THIRD FLOOR
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17110-1904
Practice Address - Country:US
Practice Address - Phone:717-782-6829
Practice Address - Fax:717-782-6831
Is Sole Proprietor?:No
Enumeration Date:2008-07-07
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD435748207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2109265OtherHIGHMARK BLUE SHEILD
PA274779OtherUNISON HEALTH PLAN (GH)
PA20091571OtherAMERIHEALTH MERCY-GH
PA102320020Medicaid
PA1583309OtherGATEWAY
PAP00903985Medicare PIN
PA20091571OtherAMERIHEALTH MERCY-GH