Healthcare Provider Details

I. General information

NPI: 1215342217
Provider Name (Legal Business Name): SUBIN MATHEW M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2014
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

988440 NEBRASKA MEDICAL CTR
OMAHA NE
68198-3609
US

IV. Provider business mailing address

988440 NEBRASKA MEDICAL CTR
OMAHA NE
68198-8440
US

V. Phone/Fax

Practice location:
  • Phone: 402-559-9953
  • Fax: 402-559-3341
Mailing address:
  • Phone: 402-559-9953
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number33430
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code2084A2900X
TaxonomyNeurocritical Care Physician
License Number33430
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: