MEDICARE: DR. G. MATT HOWARD III D.C.

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	111N00000X	Chiropractor	08000546A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000096807	OTHER	IN	ANTHEM

General Provider Information

NPI Number	:	1811955925
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. G. MATT HOWARD III D.C.

Provider Business Mailing Address
First Line	:	808 W WHITE RIVER BLVD
Second Line	:
City	:	MUNCIE
State	:	IN
Zip	:	47303-3868
Country	:	US
Telephone Number	:	765-254-9481
Fax Number	:	765-254-9493

Provider Business Practice Location Address
First Line	:	808 W WHITE RIVER BLVD
Second Line	:
City	:	MUNCIE
State	:	IN
Zip	:	47303-3868
Country	:	US
Telephone Number	:	765-254-9481
Fax Number	:	765-254-9493

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

Provider Enumeration Date	:	05/01/2006
Last Update Date	:	07/09/2007

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