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General NPI Number Information
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NPI Number | 1548766850
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Entity Type | Individual
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Provider Name | MATTHEW MARK WOLBERT DO
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Gender | Male
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Dates
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Enumeration Date | 04/04/2018
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Last Update Date | 08/12/2025
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Provider Practice Location Address
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Address Line | 9605 JEFFERSON HWY STE E
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City | RIVER RIDGE
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State | LA
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Zip | 70123-2550
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Country | US
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Telephone | 504-738-1600
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Fax | 504-737-1264
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Provider Business Mailing Address
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Address Line | 1100 POYDRAS ST 2500 ENERGY CENTER
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City | NEW ORLEANS
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State | LA
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Zip | 70163-2500
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Country | US
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Telephone | 45-527-9953
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Fax | 45-527-9950
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS020546
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 345835
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | PA
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