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Individual

DR. MATTHEW GREGORY PROHASKA JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1315 HOSPITAL DR, NVRH ORTHOPAEDICS, ST JOHNSBURY, VT 05819-9210
(802) 748-8141
Mailing address
PO BOX 905, NVRH ORTHOPAEDICS, ST JOHNSBURY, VT 05819-0905
(802) 748-8141

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
042-0013063
VT
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1024556
VT
05
3100897
NH
Enumeration date
05/08/2010
Last updated
07/06/2015
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