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Individual
MATTHEW PUDERBAUGH
Active
Individual
MATTHEW PUDERBAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
2081P0301X
Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician
Primary
70248
MN
208D00000X
General Practice Physician
5101019889
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
NULL
Other
Enumeration date
07/17/2012
Last updated
06/10/2022
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