Provider Demographics
NPI:1316144280
Name:BENTLEY, MATTHEW B (DO)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:B
Last Name:BENTLEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:MATTHEW
Other - Middle Name:BOYD
Other - Last Name:BENTLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:810 SAINT VINCENTS DR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-1601
Mailing Address - Country:US
Mailing Address - Phone:205-930-2564
Mailing Address - Fax:205-930-2469
Practice Address - Street 1:810 SAINT VINCENTS DR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-1601
Practice Address - Country:US
Practice Address - Phone:205-930-2564
Practice Address - Fax:205-930-2469
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MST-2023207R00000X
ALDO1148208M00000X
FLOS15166207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist