Healthcare Provider Details

I. General information

NPI: 1528582855
Provider Name (Legal Business Name): MATTHEW JAMES GEBING AUD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7354 S ALTON WAY STE 201
CENTENNIAL CO
80112-2357
US

IV. Provider business mailing address

7354 S ALTON WAY STE 201
CENTENNIAL CO
80112-2357
US

V. Phone/Fax

Practice location:
  • Phone: 303-649-2122
  • Fax: 303-649-9808
Mailing address:
  • Phone: 303-649-2122
  • Fax: 303-649-9808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAUD.0000864
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: