Provider Demographics
NPI:1194924621
Name:FURBER, MATT T (PA-C)
Entity type:Individual
Prefix:MR
First Name:MATT
Middle Name:T
Last Name:FURBER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2900 12TH AVE N STE 265W
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-7501
Mailing Address - Country:US
Mailing Address - Phone:406-237-7999
Mailing Address - Fax:406-237-7990
Practice Address - Street 1:2900 12TH AVE N STE 265W
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-7501
Practice Address - Country:US
Practice Address - Phone:406-237-7999
Practice Address - Fax:406-237-7990
Is Sole Proprietor?:No
Enumeration Date:2007-07-14
Last Update Date:2018-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT30875363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1194924621Medicare UPIN