Provider Demographics
NPI:1306937586
Name:SZYBNSKI, MATTHEW DOUGLAS (RPA-C)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:DOUGLAS
Last Name:SZYBNSKI
Suffix:
Gender:M
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1872 LEGACY LN
Mailing Address - Street 2:
Mailing Address - City:CHASKA
Mailing Address - State:MN
Mailing Address - Zip Code:55318-5401
Mailing Address - Country:US
Mailing Address - Phone:952-210-4405
Mailing Address - Fax:
Practice Address - Street 1:8900 HIGHWAY 7
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55426-3919
Practice Address - Country:US
Practice Address - Phone:952-935-6941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9411363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNMS1208948OtherDEA NUMBER
MNMS1208948OtherDEA NUMBER