Provider Demographics
NPI:1346239498
Name:NEUHAUS, MATTHEW D (DPM)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:D
Last Name:NEUHAUS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3024 BUSINESS PARK CIR
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-3132
Mailing Address - Country:US
Mailing Address - Phone:615-239-2018
Mailing Address - Fax:
Practice Address - Street 1:693 PRESIDENT PL STE 103
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-8601
Practice Address - Country:US
Practice Address - Phone:615-220-8788
Practice Address - Fax:615-220-8688
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-20
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN609213ES0103X
TNDPM609213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3353883Medicaid
TNP00320782OtherMEDICARE RRB
TN5556260001Medicare NSC
TN3353884Medicare PIN
TN3353883Medicaid