| Doctor Name: | MATTHEW PUDERBAUGH |
| NPI Number: | 1982959771 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | 5101019889 |
| Business Practice Address: | 86th Medical Group Unit 3215 Apo, AE - 09094 |
| Business Phone Number: | 3144792609 |
| Business Fax Number: | |
| Mailing Address: | Psc 2 Box 5471, APO |
| State: | AE |
| Postal Code: | 090120055 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 07/17/2012 |
| NPI Last Update Date: | 11/25/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 5101019889 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |