Provider Demographics
NPI:1215472626
Name:BERRY, MATTHEW (PA-C)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:BERRY
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:625 S GILBERT ST
Mailing Address - Street 2:STE 2
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-1736
Mailing Address - Country:US
Mailing Address - Phone:319-688-7376
Mailing Address - Fax:319-358-2628
Practice Address - Street 1:960 S 1ST AVE
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-5210
Practice Address - Country:US
Practice Address - Phone:319-688-7777
Practice Address - Fax:319-688-7776
Is Sole Proprietor?:No
Enumeration Date:2016-12-21
Last Update Date:2017-01-23
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant