Provider Demographics
NPI:1366472680
Name:DAAB, MATTHEW R (MD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:R
Last Name:DAAB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:TUBA CITY REGIONAL HEALTHCARE CORPORTATION
Mailing Address - Street 2:167 N. MAIN ST.
Mailing Address - City:TUBA CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86045
Mailing Address - Country:US
Mailing Address - Phone:928-283-2501
Mailing Address - Fax:904-542-7836
Practice Address - Street 1:167 N MAIN ST
Practice Address - Street 2:
Practice Address - City:TUBA CITY
Practice Address - State:AZ
Practice Address - Zip Code:86045-0600
Practice Address - Country:US
Practice Address - Phone:928-283-2501
Practice Address - Fax:904-542-7836
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ52170207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine