Doctor Name: | DR. MATTHEW ANTHONY BRIDGER |
NPI Number: | 1487639134 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 356719 |
Business Practice Address: | 223 E Town St Columbus, OH - 432154683 |
Business Phone Number: | 6145669191 |
Business Fax Number: | |
Mailing Address: | 1512 Teeway Dr, COLUMBUS |
State: | OH |
Postal Code: | 432203953 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 12/14/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 204C00000X |
License Number: | 356719 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Neuromusculoskeletal Medicine, Sports Medicine |
Taxonomy Specialization: | |
Taxonomy Definition: |