MEDICARE: MR. MATT E. HERBER MD

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
1	207Q00000X	Family Medicine Physician	5054	SD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0040598	OTHER	SD	WELLMARK BCBS OF SD
3	237207	OTHER		MIDLANDS CHOICE
4	4996051	OTHER	SD	WELLMARK BCBS OF SD
5	5054	OTHER	SD	DAKOTACARE
6	AH9021031595	OTHER		PREFERRED ONE
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	57022A012	OTHER		TRICARE
9	70R64HE	OTHER	MN	BCBS OF MN
10	1675123	OTHER		AMERICAS PPO
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760451660
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MATT E. HERBER MD

Provider Business Mailing Address
First Line	:	111 10TH STREET E
Second Line	:
City	:	DELL RAPIDS
State	:	SD
Zip	:	57022-1208
Country	:	US
Telephone Number	:	605-428-5446
Fax Number	:

Provider Business Practice Location Address
First Line	:	111 10TH STREET E
Second Line	:
City	:	DELL RAPIDS
State	:	SD
Zip	:	57022-1208
Country	:	US
Telephone Number	:	605-428-5446
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/15/2006
Last Update Date	:	08/23/2010

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Directions to “ MR. MATT E. HERBER MD” Practice Location

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