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NPI Code Detail

MEDICARE: DR. MATTHEW THOMAS BADER M.D.

MEDICARE: DR. MATTHEW THOMAS BADER M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician2014-00872NC
22084P0802XAddiction Psychiatry Physician2014-00872NC

General Provider Information

NPI Number : 1518192350
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MATTHEW THOMAS BADER M.D.
Provider Business Mailing Address
First Line : 3710 UNIVERSITY DR STE 100
Second Line :
City : DURHAM
State : NC
Zip : 27707-6208
Country : US
Telephone Number : 919-906-4390
Fax Number : 919-287-2707
Provider Business Practice Location Address
First Line : 3710 UNIVERSITY DR STE 100
Second Line :
City : DURHAM
State : NC
Zip : 27707-6208
Country : US
Telephone Number : 919-906-4390
Fax Number : 919-287-2707
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2009
Last Update Date : 11/05/2025

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