Provider Demographics
NPI:1306966965
Name:REED, MATTHEW TODD (MD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:TODD
Last Name:REED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1035 N EMPORIA ST STE 105
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67214-2943
Mailing Address - Country:US
Mailing Address - Phone:316-263-7285
Mailing Address - Fax:318-263-2666
Practice Address - Street 1:1035 N EMPORIA ST STE 105
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-2943
Practice Address - Country:US
Practice Address - Phone:316-263-7285
Practice Address - Fax:318-263-2666
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2010-04-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS0433040207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200565870AMedicaid
KS200565870AMedicaid