Provider Demographics
NPI:1467454454
Name:SUTER, MATTHEW G (DC)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:G
Last Name:SUTER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1770 STEFKO BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-6262
Mailing Address - Country:US
Mailing Address - Phone:610-691-5800
Mailing Address - Fax:610-691-5825
Practice Address - Street 1:1770 STEFKO BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-6262
Practice Address - Country:US
Practice Address - Phone:610-691-5800
Practice Address - Fax:610-691-5825
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC008986111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1401126OtherBC/BS ASSIGNMENT ACCOUNT
PA1401126OtherBC/BS ASSIGNMENT ACCOUNT