Provider Demographics
NPI:1457517427
Name:SCHOMBURG, MATTHEW (AUD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:SCHOMBURG
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1022 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-1956
Mailing Address - Country:US
Mailing Address - Phone:724-282-8491
Mailing Address - Fax:
Practice Address - Street 1:1701 3RD ST
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-2432
Practice Address - Country:US
Practice Address - Phone:724-775-4327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-30
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT006080231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist