Individual
DR. MATTHEW DALLAS VIBBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
909 WALNUT STREET, COB, 2ND FLR, PHILADELPHIA, PA 19107-5211
(215) 955-7000
(215) 503-7007
Mailing address
909 WALNUT STREET, COB, 2ND FLR, PHILADELPHIA, PA 19107-5211
(215) 955-7000
(215) 503-7007
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
MD440582
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0199915
—
NJ
05
—
102501633
—
PA
Enumeration date
12/19/2007
Last updated
11/20/2014
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