Provider Demographics
NPI:1457555203
Name:HUBBARD, MATTHEW OWEN (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:OWEN
Last Name:HUBBARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:101 E OLNEY AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19120-2470
Mailing Address - Country:US
Mailing Address - Phone:215-456-7000
Mailing Address - Fax:215-456-5926
Practice Address - Street 1:60 TOWNSHIP LINE RD
Practice Address - Street 2:
Practice Address - City:ELKINS PARK
Practice Address - State:PA
Practice Address - Zip Code:19027-2220
Practice Address - Country:US
Practice Address - Phone:215-663-6422
Practice Address - Fax:215-663-6443
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2019-04-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH57011571208600000X
TN51578208600000X
CT54436208600000X
PAMD466577208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery