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NPI Code Detail

MEDICARE: MATTHEW VANDEHEI

MEDICARE:   MATTHEW  VANDEHEI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician80124WI
2207P00000XEmergency Medicine PhysicianTL.0007154CO
3390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1720584188
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW VANDEHEI
Provider Business Mailing Address
First Line : 7974 UW HEALTH CT
Second Line :
City : MIDDLETON
State : WI
Zip : 53562-5531
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 600 HIGHLAND AVE
Second Line :
City : MADISON
State : WI
Zip : 53792-4507
Country : US
Telephone Number : 608-262-2398
Fax Number : 608-262-9999
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2018
Last Update Date : 06/30/2022

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