Individual
MATTHEW E DUBAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., FACEP
Contact information
Practice address
1 MEMORIAL DR, ALTON, IL 62002-6722
(618) 463-7311
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036-079250
IL
207P00000X
Emergency Medicine Physician
2002031637
MO
207P00000X
Emergency Medicine Physician
9900480
NC
207P00000X
Emergency Medicine Physician
J5749
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036079250
—
IL
05
—
036079250-3
—
IL
05
—
204989404
—
MO
Enumeration date
07/17/2006
Last updated
03/23/2020
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