Individual
MATTHEW STAUBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
4355 FERGUSON DR, CINCINNATI, OH 45245-5136
(513) 232-2663
(859) 817-7848
Mailing address
560 S LOOP RD, EDGEWOOD, KY 41017-3405
(859) 301-2663
(859) 817-7848
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.006827RX
OH
Other
Enumeration date
10/05/2021
Last updated
11/23/2021
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