Healthcare Provider Details

I. General information

NPI: 1437511979
Provider Name (Legal Business Name): MATTHEW DOERS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2016
Last Update Date: 02/16/2022
Certification Date: 02/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7700 UNIVERSITY DR
WEST CHESTER OH
45069-2505
US

IV. Provider business mailing address

234 GOODMAN ST ML 0781
CINCINNATI OH
45219-2364
US

V. Phone/Fax

Practice location:
  • Phone: 513-475-8523
  • Fax: 513-475-7327
Mailing address:
  • Phone: 513-584-4505
  • Fax: 513-584-0468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number35.137465
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.137465
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number57.027626
License Number StateOH
# 5
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number35.137465
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: