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Individual
BRUCE H MATT
Active
Individual
BRUCE H MATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
01037542A
IN
207YP0228X
Pediatric Otolaryngology Physician
Primary
01037542A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000083127
ANTHEM PTAN
IN
05
—
100320610
—
IN
01
—
1102504467
ANTHEM PTAN
IN
Enumeration date
07/10/2006
Last updated
04/14/2025
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