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General NPI Number Information
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NPI Number | 1396253365
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Entity Type | Individual
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Provider Name | MATTHEW SHANE CUMMINGS
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Gender | Male
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Dates
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Enumeration Date | 01/12/2018
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Last Update Date | 01/12/2018
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Provider Practice Location Address
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Address Line | 1451 S GREEN ST
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City | BROWNSBURG
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State | IN
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Zip | 46112-2044
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Country | US
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Telephone | 317-858-8444
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Fax |
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Provider Business Mailing Address
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Address Line | 10 FLETCHER PL
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City | DANVILLE
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State | IL
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Zip | 61832-1811
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Country | US
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Telephone | 217-497-7654
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 17001191A
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License Number State | IN
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