Provider Demographics
NPI:1952334468
Name:TING, MATTHEW H (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:H
Last Name:TING
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:909 E MONTCLAIR ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-5068
Mailing Address - Country:US
Mailing Address - Phone:417-882-4466
Mailing Address - Fax:417-890-5631
Practice Address - Street 1:909 E MONTCLAIR ST
Practice Address - Street 2:SUITE 120
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-5068
Practice Address - Country:US
Practice Address - Phone:417-882-4466
Practice Address - Fax:417-890-5631
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2014-12-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO113753207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO208870303Medicaid
MOG59079Medicare UPIN
MO958784999Medicare ID - Type UnspecifiedMEDICARE PROVIDER #
MO208870303Medicaid